Aorto-bronchial fistula following aortic and bronchial stenting of a thoracic aneurysm

Abstract

A 66-year-old man underwent repair of an abdominal aortic aneurysm and synchronous stenting of a thoracic aneurysm compressing his left main bronchus. This resulted in further bronchial compression which was also stented. An aorto-bronchial fistula resulting in severe haemoptysis occurred a few weeks later. This was successfully treated with repeat endovascular stenting and left pneumonectomy. Open repair should be the treatment of choice for thoracic aneurysms with bronchial compression.

Thoracic endovascular repair as a safe management strategy for aortobronchial fistulas

“…The characteristics and diagnostic workup of our patients mirror those reported in similar case reports and meta-analyses. [24][25][26][27][28][29][30][31][32][33][34] Notably, our treatment group had a nearly even distribution of men and women, all patients presented with hemoptysis, and each received a CT as part of the initial diagnostic work-up. Though CTA was successful in demonstrating thoracic aortic pathology and adjacent lung parenchymal changes, no ABF were visualized as a direct result of this diagnostic test.…”

Fatal Bronchovascular Fistula after a Single Lung Transplantation: A Case Report

“…Davidson et al9 reported a case of a pulmonary artery-to-bronchial stump fistula after a right upper lobectomy that was successfully treated with endovascular placement of a covered stent. Management by endovascular stent placement has been primarily used for aortobronchial fistulas related to aneurysms or pseudoaneurysms of the descending thoracic aorta with successful occlusion 10,11,12. Unfortunately, urgent treatment of our patient was not possible, and the patient died shortly after arriving in the emergency room.…”

A near fatal complication following stenting of thoracic aortic aneurysm

“…[7] However, if both, the thoracic aorta and the left bronchus are stented, the extrinsic pressure of the stented thoracic aneurysm may lead to a delayed aorto-bronchial fistula and pulmonary hemorrhage after stent implantation in the bronchus. [8]…”