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Once considered a harmless alternative to smoking tobacco, e-cigarettes are now a public health threat. Occupational health nurses should recommend workers avoid using e-cigarettes and vaping unless suggested by their doctor for smoking cessation purposes.Aortoduodenal fistula after endovascular treatment of abdominal aortic aneurysm is a very rare but life-threatening complication. Herein, we describe 4 cases of aortoduodenal fistula diagnosed at 15 to 78 months after the index aortic intervention, all successfully treated by surgery.