Saphenous Vein Spiral Graft: Successful Emergency Repair of a Mycotic Aneurysm with Aortoduodenal Fistula

• Published in: European journal of vascular and endovascular surgery Vol. 32; no. 4; pp. 408 - 410
• Main Authors: Heikens, J.T., Coveliers, H.M.E., Burger, D.H.C., van Berge Henegouwen, D.P., Vriens, P.W.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-10-2006
• Subjects: Aged; Aneurysm, Infected - complications; Aneurysm, Infected - surgery; Aortic Aneurysm, Abdominal - complications; Aortic Aneurysm, Abdominal - surgery; Aortic Diseases - etiology; Aortic Diseases - surgery; Aortic Rupture - complications; Aortic Rupture - surgery; Aortoduodenal fistula; Duodenal Diseases - etiology; Duodenal Diseases - surgery; Emergency Treatment; Escherichia coli Infections - complications; Escherichia coli Infections - surgery; Female; Humans; Infrarenal aorta; Intestinal Fistula - etiology; Intestinal Fistula - surgery; Mycotic aneurysm; Saphenous Vein - transplantation; Saphenous vein spiral graft; Tissue and Organ Harvesting - methods; Vascular Fistula - etiology; Vascular Fistula - surgery; Mycotic aneurysm; Aortoduodenal fistula; Saphenous vein spiral graft; Infrarenal aorta
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2006.04.016

Mycotic aneurysms leading to aortoduodenal fistula (ADF) are associated with high morbidity and mortality. We report a patient with a mycotic aneurysm and ADF who required emergency laparotomy. After excision of the aneurysm, vascular reconstruction was performed using an autologous graft. The left long saphenous vein was harvested and constructed into a spiral graft. The graft was inserted using a standard inlay technique. After 12 months the patient is in good health. No inflammation or dilation of the saphenous vein spiral graft has been noted.
We suggest that in the emergency treatment of mycotic abdominal aneurysm, aortic reconstruction with saphenous vein spiral graft is a valuable option.