To the editor:We report a case of aortoduodenal fistula presenting as right lower limb ischemia and infection after endovascular aortic repair (EVAR) of an infected abdominal aortic aneurysm (AAA).A right above knee amputation was performed for the septic embolism of the ilio-femoral arteries before the stent-graft infection was finally diagnosed.Then an extra-anatomic revascularization of the left lower limb,following by explantation of the infected stent-graft and rebuilding of the gastro-intestinal continuity were done.To our knowledge,this is the first case successfully treated by this method in China.