Aorto-bronchial and aorto-pulmonary fistulation after thoracic endovascular aortic repair: an analysis from the European Registry of Endovascular Aortic Repair Complications

Czerny, Martin; Reser, Diana; Eggebrecht, Holger; Janata, Karin; Sodeck, Gottfried; Etz, Christian D.; Luehr, Maximilian; Verzini, Fabio; Loschi, Diletta; Chiesa, Roberto; Melissano, Germano; Kahlberg, Andrea; Amabile, Philippe; Harringer, Wolfgang; Jánosi, Rolf Alexander; Erbel, Raimund; Schmidli, Jürg; Tozzi, Piergiorgio; Okita, Yutaka; Canaud, Ludovic; Khoynezhad, Ali; Maritati, Gabriele; Cao, Piergiorgio; Kölbel, Tilo; Trimarchi, Santi

doi:10.1093/ejcts/ezu443

Cited by 58 publications

(40 citation statements)

References 14 publications

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“…123,128 Open surgical treatment remains the first choice for patients fit for surgery as the EuREC registry showed that a radical surgical approach resulted in significantly better survival (63% at two years) compared with any other treatment strategy. 98 To decrease the risk of ABF recurrence and re-infection, the bronchial defect needs to be repaired surgically. The defect can be closed primarily or with an intercostal muscle or pericardial flap, but in most cases a bronchial resection and anastomosis or a lung resection (mostly wedge resection) is necessary.…”

Section: Open Surgical Treatmentmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections

Chakfé

Diener

Lejay

et al. 2020

European Journal of Vascular and Endovascular Surgery

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316

286

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DEDICATIONAfter studying medicine at Hanover Medical School and philosophy and social psychology at the Leibniz University Hanover, Omke E. Teebken joined the Christian Albrechts University in Kiel at the end of the 1990s as a research fellow at the Clinic for Cardiovascular Surgery headed by Professor Dr Axel Haverich, whom Omke E. Teebken later followed back to Hanover.In Hanover, besides working as a clinician, Omke E.Teebken was particularly active scientifically, contributing to the establishment of the then newly founded Leibniz Laboratories for Biotechnology and Artificial Organs (LEBAO). His work focused on regenerative medicine and tissue engineering, and subsequently he wrote his habilitation thesis in in this field. After basic training in cardiac surgery, he specialised clinically in vascular surgery and played a pioneering role in the development of this field. Before being appointed director of the Clinic for Vascular Surgery e Endovascular Surgery at the Peine Clinic in 2016, Omke E. Teebken headed the Vascular Surgery e Endovascular Surgery Division of the Department of Cardiothoracic, Thoracic, Transplantation and Vascular Surgery at Hanover Medical School. Professor Teebken was a highly appreciated, committed, and competent colleague and teacher.On 8 April 2019, Professor Teebken passed away after a short and severe illness. He was member and author of the ESVS guideline writing committee, an esteemed colleague, and friend.We will always honor his memory.

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Section: Open Surgical Treatmentmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections

Chakfé

Diener

Lejay

et al. 2020

European Journal of Vascular and Endovascular Surgery

Self Cite

316

286

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“…Aortobronchial fistula following TEVAR for TBAD is even rarer, with a reported incidence ranging from 0.2% to 0.8%. [126][127][128] Both complications may also develop after TEVAR from resorption of hematoma, as this resorption may cause wall fatigue and fistulation. 129 Stent-graft explantation may be necessary in particular cases of stent-graft failure.…”

Section: Rare Complicationsmentioning

confidence: 99%

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

et al. 2015

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Thoracic endovascular aortic repair (TEVAR) has evolved into an established treatment option for type B aortic dissection (TBAD) since it was first introduced 2 decades ago. Morbidity and mortality have decreased due to the minimally invasive character of TEVAR, with adequate stabilization of the dissection, restoration of true lumen perfusion, and subsequent positive aortic remodeling. However, several studies have reported severe setbacks of this technique. Indeed, little is known about the biomechanical behavior of implanted thoracic stent-grafts and the impact on the vascular system. This study sought to systematically review the performance and behavior of implanted thoracic stent-grafts and related biomechanical aortic changes in TBAD patients in order to update current knowledge and future perspectives.

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“…APF or AEF has been shown to be rare (incidence of 0%-1%), but fatal, after hybrid arch repair. 12 In our study, APF and AEF were not rare (3/65 [5%]). Similar to other studies, the outcomes related to APF and AEF in our study were very poor (mortality of 2/3 [67%]).…”

Section: Discussionmentioning

confidence: 44%

Late complications after hybrid aortic arch repair

Joo

Youn

Kwon

et al. 2019

Journal of Vascular Surgery

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Objective: Although hybrid arch repair has gained widespread application as an alternative option for high-risk patients, concerns about its long-term durability remain an important issue. The aim of this study was to investigate late complications after hybrid arch repair.Methods: From January 2002 to December 2017, hybrid arch repair was performed in 65 patients with aortic arch disease (median age, 66.1 years; range, 41-86 years). Hybrid arch repair was defined as debranching involving at least one supraaortic vessel bypass and simultaneous or staged endovascular thoracic stent grafting. We retrospectively analyzed late complications including reintervention, open conversion, and aortic-related death. The median follow-up period was 60.1 months (range, 1-170 months).Results: The in-hospital mortality rate was 6% (4/65). Except for early death (n ¼ 4) and early open conversion (n ¼ 2), late complications were observed in 25 patients (25/59 [42%]). The median time interval between the initial procedure and late complication was 36.6 months (range, 1-92 months). Late complications included delayed type I endoleak (n ¼ 8), distal stent-induced new entry (n ¼ 3), stent migration (n ¼ 3), retrograde type A dissection (n ¼ 2), aortopulmonary fistula (n ¼ 2), aortoesophageal fistula (n ¼ 1), stent fracture (n ¼ 1), infection (n ¼ 1), and sudden death (n ¼ 4). Six of these patients (10%) underwent late open conversion. The overall survival rates at 3 years and 6 years were 71.1 6 7.4% and 57.2 6 11.3%, respectively. The aortic event-free rates at 3 years and 6 years were 52.1 6 7.3% and 39.4 6 10.3%, respectively.Conclusions: Late complications in hybrid arch repair occurred in a substantial proportion of patients during midterm follow-up. Regardless of zone type, the incidence of late complications was relatively high. This study suggests that timely reintervention and open conversion are important for rescuing patients, but repeated reinterventions and conservative strategies are not recommended. Aggressive management and life-long surveillance after hybrid arch repair are mandatory for better outcomes. (J Vasc Surg 2019;70:1023-30.)

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Aorto-bronchial and aorto-pulmonary fistulation after thoracic endovascular aortic repair: an analysis from the European Registry of Endovascular Aortic Repair Complications

Cited by 58 publications

References 14 publications

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

Late complications after hybrid aortic arch repair

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