Embolization of Postsurgical Esophagopleural Fistula with AMPLATZER Vascular Plug, Coils, and Histoacryl Glue

Koo, Jae-Mean; Park, Kwang Bo; Choo, Sung Wook; Kim, Kwhanmien; Soo, Young

doi:10.1016/j.jvir.2010.09.004

Cited by 16 publications

(13 citation statements)

References 12 publications

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“…Recently, new treatment methods of esophagopleural fistulas can be used, such as endovac therapy or vascular plug, coils and surgical glue, thus avoiding extensive surgery or covered stent insertion (34). Chylotorax is a rare complication after thoracic surgery, occurring in 0.5% to 2% after esophagectomy (35,36) and 1.4% to 2.3% after lung resection (37,38).…”

Section: Discussionmentioning

confidence: 99%

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Gîndea¹,

Constantin²,

Hoara³

et al. 2018

chr

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RezumatIntroducere: Diverticulul esofagian toracic reprezintă o patologie rară, frecvent asociată cu tulburări de motilitate esofagiană. Chirurgia reprezintă singura opţiune terapeutică la pacienţii cu simptome severe. Metodă: Studiu retrospectiv pe un lot de 10 pacienţi ce au suferit diverticulectomie pentru simptomatologia provocată de diverticulii epifrenici sau medio-toracici. Au fost înregistrate principalele simptome preoperatorii, analizele de sânge uzuale, tranzitul baritat, endoscopia superioară şi manometria esofagiană. Am analizat complicaţiile postoperatorii, durata de spitalizare şi perioada petrecută la terapie intensivă. Rezultate: Majoritatea pacienţilor au prezentat regurgitaţii, disfagie sau ambele. Abordul chirurgical a fost prin toracotomie stângă sau pe cale abdominală pentru diverticulii epifrenici şi prin toracotomie dreaptă sau toracoscopie pentru diverticulii mediotoracici. 4 pacienţi au prezentat complicaţii severe: 3 fistule majore (un deces) şi un chilotorax. Discuţii: Chirurgia diverticulilor toracici este asociata cu rate mari de mobiditate şi mortalitate. Fistula produsă la nivelul liniei de sutură este cea mai frecventa complicaţie, spre deosebire de chilotorax ce survine mai rar. Concluzii: Diverticulul esofagian toracic voluminos este o patologie benignă cu complicaţii "maligne". O evaluare preoperatorie Chirurgia, 113 (1), 2018 www.revistachirurgia.ro 145

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Section: Discussionmentioning

confidence: 99%

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Gîndea¹,

Constantin²,

Hoara³

et al. 2018

chr

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“…Traditional surgical approaches involve either primary suturing or segmental oesophagectomy, but are complex and associated with high morbidity (30%-50%) and mortality (10%). 11 Bypass and muscle flap buttressing are newer operations possible for the debilitated. 12,13 Embolisation with vascular plug and coils under fluoroscopy has been reported in one article.…”

Section: Discussionmentioning

confidence: 99%

Retrievable endoscopic stenting for tuberculous oesophagopleural fistula with empyema

Chan¹,

Chan²

2017

Hong Kong Med J

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A 23-year-old female was admitted for fever, cough, and right pleuritic pain in January 2015. Chest X-ray revealed right pleural effusion. Subsequent computed tomography of the thorax demonstrated necrotising pneumonitis in the right lower lobe, with large right empyema and multiple left lung centrilobular nodules suspicious of tuberculosis (Fig 1a). On admission, haemoglobin level was only 84 g/L. Oesophagogastroduodenoscopy (OGD) found a linear deep oesophageal ulceration with suspected fistula opening (Fig 1b), biopsy of which

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“…10 The first case report describing the successful use of an Amplatzer occluder to close an esophagopleural fistula was reported in 2010. 11 In that case, the device was implanted 7 days following surgical resection of an esophageal diverticulum, and a liquid polymer was also used to provide immediate sealing. In 2013, a second case report described a patient who developed an esophagopleural fistula following a left pneumonectomy.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Successful Closure of an Esophagopleural Fistula With an Amplatzer Occluder Sealed With Liquid Copolymer, With 3-Year Follow-Up and Review of Literature

Lassaletta

Laham

Pinto

et al. 2016

PLEURA

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Esophageal perforations may recur, and/or develop a mature fistulous tract to the pleura, despite prompt surgical management. Treatment of a chronic esophageal fistula is challenging and may require multiple reoperations. We describe the closure of a controlled, chronic, benign esophagopleural fistula using an Amplatzer occluder and sealed with a liquid copolymer after failed open repair. At 3 years postprocedure, the patient has no further recurrence or complication associated with the repair. Amplatzer plugs and occluders, designed for endovascular and cardiac procedures, are increasingly used off-label for the treatment of complex, recurrent, or otherwise difficult to manage bronchopulmonary, pleural, and esophageal fistulae.The patient is a 59-year-old woman, current smoker, otherwise healthy, who presented to an outside institution 1 year prior with a spontaneous esophageal perforation. Athough she did have a remote history of alcohol abuse, she denied any recent emesis or retching. She presented several days after the onset of symptoms, and consequently primary repair of the perforation was not attempted. The perforation was accessed via a right thoracotomy, treated with wide drainage, and healed over the subsequent 2 months with nutritional support and a prolonged hospital course.Four months later, she presented with recurrent fever and chest pain. A barium esophagogram demonstrated extravasation of contrast into the right pleural space (Figure 1). Again, right thoracotomy was performed, and primary repair of the perforation was undertaken. However, the fistula recurred and failed to close over the following weeks, despite adequate drainage and nutritional support with jejunal tube feeding.The patient was subsequently transferred to our institution for further management. Given that the fistula was chronic and failed to close after attempted primary repair and prolonged drainage, we elected to place a self-expanding, fully covered metal stent (23 Â 105 mm WallFlex; Boston Scientific, Natick, Massachusetts; Figure 2). However, the stent migrated into the stomach, despite securing the stent to the mucosa with clips. Of note, there was neither a stricture nor a mass distal to the perforation, upper endoscopic examination was otherwise normal to the duodenum, and there was no appreciable obstruction or holdup of contrast during barium esophagogram.Consequently, we elected to attempt closure of the esophagopleural fistula with an Amplatzer endovascular ventricular septal defect (VSD) occluder (St Jude Medical, St Paul, Minnesota). This procedure was performed under general anesthesia in the operating room. Under endoscopic

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Embolization of Postsurgical Esophagopleural Fistula with AMPLATZER Vascular Plug, Coils, and Histoacryl Glue

Cited by 16 publications

References 12 publications

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Retrievable endoscopic stenting for tuberculous oesophagopleural fistula with empyema

Successful Closure of an Esophagopleural Fistula With an Amplatzer Occluder Sealed With Liquid Copolymer, With 3-Year Follow-Up and Review of Literature

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