Saturday, September 28, 2019

Aortic Grafts

A paper which examines the diagnosis and treatment of an aortic graft to a duodenum fistula as a cause for upper GI bleeding. This paper examines the connection between an aortic graft to a duodenum fistula as a cause for upper GI bleeding. Generally, aortic grafts are used to treat abdominal aortic aneurysms. The paper defines aortic aneurysms as a weak area in the wall of the abdominal aorta, the artery that carries blood from the heart to the rest of the body. The paper concludes that aortic grafting can be a major cause of GI bleeding as an after effect of treating an abdominal aortic aneurysm and a method of treatment requires replacement of the stent-graft. Treatment of abdominal aortic aneurysms may require surgery but for some patients, a new non-surgical treatment called stent-graft repair can be performed. The following is the results of a prospective, nonrandomized, multicenter clinical trial that compared endovascular stent graft exclusion of abdominal aortic aneurysms with open surgical repair. During an 18-month period, 250 patients with infrarenal aneurysms underwent treatment at 12 study sites. 190 patients underwent endovascular repair using the Medtronic AneuRx stent graft (Sunnyvale, California), and 60 underwent open surgical repair. There was no significant difference in operative mortality rates between the groups. The patients who underwent stent grafting had significant reductions in blood loss and days in the intensive care unit and in the hospital, with an earlier return to function. Primary technical success at the time of discharge for the patients with stent grafts was 77%, largely as a result of a 21% endoleak rate. At one month, the endoleak rate had decreased to 9%.

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