We would like to thank S Duvnjak et al. for their comments. In our case report,
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we elaborated on a complicated case in which the patient developed vascular graft infection years after endovascular repair of an acutely bleeding aortic stump. We stated that in such cases the endovascular salvage repair should be followed by a more definitive treatment when the patient is fit for surgery, especially for of aortoduodenal fistula cases. However, we also expressed our thoughts on patients who are unfit for surgery; they may well benefit from a more conservative approach with culture based antibiotic therapy, making this second best treatment option a reasonable alternative.S Duvnjak et al. described a case
2
in which their patient died two years after endovascular intervention for an aortic stump bleed due to a new bleeding complication. This case adds to our above mentioned perspective and suggests that personalised medicine plays a crucial role in the treatment of these vulnerable patients.References
- Endovascular treatment of aortic stump blow-out after extra-anatomical repair of aortoduodenal fistula: a case report and review of literature.CVIR Endovasc. 2020 Apr 13; 3: 21
- Endovascular repair of postoperative vascular graft related complications after aorto-iliac surgery.Int Angiol. 2014 Aug; 33: 386-391
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Publication history
Published online: October 21, 2022
Accepted:
October 18,
2022
Received:
October 16,
2022
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- Regarding the Case Report from Elise Beijer, et al. Published in Volume 55, 2022; Vascular Forum. “Endovascular Treatment of Aortic Stump Rupture after Extra-anatomic Aortoduodenal Fistula Repair is not a Definitive Treatment: A Case Report and Literature Review”EJVES Vascular ForumVol. 57
- PreviewDear Editor and Author, I read carefully your report and congratulations on the nice description and highly skilled treatment. As we all know, vascular graft infections are devastating complications accompanied by high mortality and morbidity rates. The endovascular solution is used either as a bridging or definitive treatment. In the real world, the bridging option becomes a definite solution due to difficulties with open surgery and a high mortality rate. There is limited literature available and as you noted usually case reports.
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