Successful treatment of graft-duodenal fistula after renovisceral debranching thoracic endovascular aortic repair with limited graft resection based on 18F-fluorodeoxyglucose positron emission tomography with computed tomography

Abstract

We present the case of a patient with a graft-duodenal fistula after renovisceral debranching thoracic endovascular aortic repair. 18F-fluorodeoxyglucose positron emission tomography with computed tomography showed that the infection was localized to the renovisceral bypass grafts and the right kidney. Based on the preoperative imaging findings, a limited surgery with resection was performed in the fistula, right kidney, and fluorodeoxyglucose-positive bypass grafts, while preserving the fluorodeoxyglucose-negative grafts. No signs of reinfection were reported 2 years after the surgery. Accurate assessment of infection with 18F-fluorodeoxyglucose positron emission tomography with computed tomography may be useful for performing adequate excision of infected lesions.