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Mycotic aortic aneurysms account for 1–3% of all aortic aneurysms. The management of this disease is controversial. Since open surgical repair is associated with high morbidity and mortality rates, endovascular aneurysm repair is an alternative treatment method with promising early and midterm outcomes, although its long-term durability is unknown. Secondary aortoenteric fistulas may occur iatrogenically after either aortic reconstructive surgery or endovascular repair. As the number of aneurysms managed with endovascular aneurysm repair has substantially increased, cases of aortoenteric fistulas referred for endovascular repair are augmented. We report the case of an aortoduodenal fistula manifested with duodenal perforation after staged endovascular and surgical treatment of a mycotic aortic aneurysm.

Accurate measurements of arterial anatomy are emerging as the most important determinants of endovascular abdominal aneurysm repair. It is quite difficult to define and measure arterial anatomy features quantitatively due to the complex structure of the aneurysm and insufficient visual feedback. During decision making, to assist operators in diagnosing abdominal aortic aneurysms, a specialized preprocessing Abdominal Aortic Aneurysm Measurement and Evaluation Tool (AMET) was developed. AMET provides visual interfaces with broad measurement capabilities to generate a 3D model of the aorta for a better diagnosis and accurate stent selection. The accuracy and usability of the tool was tested with a series of measurements that were carried out on a selected patient group. The obtained statistical results were evaluated and compared with the current applied method used by the radiodiagnostic department. Test results showed that the new introduced measurement and evaluation tool, AMET, has higher measurement quality compared to the conventional manual method.