Temporary Endovascular Control of a Bleeding Aortoenteric Fistula by Transcatheter Coil Embolization

A 67-year-old man presented with gastrointestinal bleeding resulting from a fistula between the aortic stump and the fourth part of the duodenum 14 months after an axillobifemoral bypass, graft excision, and aortic stump closure for aortic graft infection. The patient initially refused any attempt at definitive surgical treatment so coil embolization of the aortic stump was performed via a brachial approach. Coil embolization may be a useful adjunct in the management of such difficult problems. This approach may buy time and allow careful planning of a definitive treatment or may serve as a palliative procedure in inoperable patients.