Aortoesophageal fistula: an uncommon complication after stent-graft repair of an aortic thoracic aneurysm

Isasti, Guillermo; Gómez‐Doblas, Juan José; Olalla, Eduardo

doi:10.1510/icvts.2009.207910

Cited by 37 publications

(21 citation statements)

References 6 publications

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“…AEF is a well-known complication of open surgical repair of thoracic aneurysms [7,8]. Aortoenteric fistula, as a rare complication of endovascular prosthetic stent-grafting of aneurysms of the thoracic and abdominal aorta, is seen more commonly, due to the increasing frequency of usage of this treatment method in recent years.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

Numan

Gülşen

Cantasdemir

et al. 2011

Cardiovasc Intervent Radiol

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A 68-year-old man who was subjected to stent-grafting of a descending thoracic aortic aneurysm (TAA) 4 months previously was admitted to our hospital with constitutional symptoms, including high fever, sweating, nausea, vomiting, weight loss, and backache. An infected aneurysmal sac was suspected based on computed tomography (CT) findings, and an aortoesophageal fistula (AEF) was identified during esophagoscopy. CT-guided aspiration was performed using a 20-G Chiba needle, confirming the presence of infection. For treatment of the infected aneurysmal sac, CT-guided percutaneous catheter drainage in a prone position was performed under general anesthesia with left endobronchial intubation. Drainage catheter insertion was successfully performed using the Seldinger technique, which is not a standard treatment of an infected aneurysmal sac. Improvement in the patient's clinical condition was observed at follow-ups, and CT showed total regression of the collection in the aneurysmal sac.

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Section: Discussionmentioning

confidence: 99%

“…As a surgical option, left thoracotomy with subsequent aortic graft replacement and esophageal fistula resection may be appropriate AEF therapy [3,7]. Temporary or permanent extra-anatomic bypass can be performed in the presence of no active bleeding.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

Numan

Gülşen

Cantasdemir

et al. 2011

Cardiovasc Intervent Radiol

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“…The most common EGD finding of AEF is a sub-mucosal tumor-like protrusion with/without clots/debris due to extrinsic compression on the esophageal wall. Other reported EGD findings included ulcerative lesions, oozing from a pin-hole erosion or a pulsating protrusion with fistula, which might be related to graft exposure [35,49,50]. Interestingly, AEF is usually observed between the posterior to left lateral wall of the upper/middle-esophagus in the endoscopic findings.…”

Section: Importance Of Early Diagnosis Of Post-tevar Aefmentioning

confidence: 97%

Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature

Uno

Koike

Takahashi

et al. 2017

Clin J Gastroenterol

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Aorto-esophageal fistula (AEF) is a rare and lethal entity, and the difficulty of making diagnosis of AEF is well-known. As promising results in the short-term effectiveness of thoracic endovascular aortic repair (TEVAR) promote its usage, the occurrence of AEF after TEVAR (post-TEVAR AEF) increases as one of the major complications. Therefore, we provide a review concerning the management strategy of post-TEVAR AEF. Although its representative symptom was reported as the triad of mid-thoracic pain and sentinel hematemesis followed by massive hematemesis, the symptom-free interval between sentinel hemorrhage and massive exsanguination is unpredictable. However, the physiological condition represents a surgical contraindication. Accordingly, early diagnosis is important, but either CT or esophago-gastroduodenoscopy rarely depicts a typical image. The formation of post-TEVAR AEF might be associated with the infection of micro-organisms, which is uncontrollable with anti-biotic administration. The current first-line strategy is combination therapy as follows, (1) to control bleeding by TEVAR in the urgent phase, and (2) radical debridement and aortic/esophageal re-construction in the semi-urgent phase. In view of the high mortality and morbidity rate, it is proposed that the choice in treatment strategies might be affected by patient's condition, size of the wall defects and the etiology of AEF. Practically, we should keep in mind the importance of making an early diagnosis and, once a suspicious symptom has occurred in a patient with a history of TEVAR, the existence of post-TEVAR AEF should be suspected. A prospective registry together with more developed technologies will be needed to establish a future strategy.Keywords Aorto-esophageal fistula Á Thoracic endovascular aortic repair Á Thoracic aortic aneurysm Á Endoscopy Á Surgery Abbreviations

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“…), so dass die Mediastinitis prolongiert mit Breitspektrumantibiotika behandelt werden sollte [12]. Successful treatment of secondary aortoesophageal fistula after thoracic endovascular aortic repair 5 History and clinical symptoms: A 58-year-old man was admitted to our hospital with acute chest pain and subfebrile temperatures.…”

Section: Therapie Und Verlaufmentioning

confidence: 99%

Erfolgreiche Therapie einer sekundären aortoösophagealen Fistel nach Implantation eines endovaskulären Aortenstentgrafts

H¹,

Paul²,

Niebel³

et al. 2010

Dtsch med Wochenschr

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Aortoesophageal fistula: an uncommon complication after stent-graft repair of an aortic thoracic aneurysm

Abstract: AEF is a catastrophic complication of endovascular stent-graft placement. Treatment options are very limited, as these patients are usually not candidates for open surgery. Conservative treatment is often associated with fatal results.

Cited by 37 publications

References 6 publications

Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

Percutaneous Treatment of an Infected Aneurysmal Sac Secondary to Aortoesophageal Fistula with a History of Stent-Graft Treatment for Thoracic Aortic Aneurysm

Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature

Erfolgreiche Therapie einer sekundären aortoösophagealen Fistel nach Implantation eines endovaskulären Aortenstentgrafts

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