pTEVAR of an aorto-esophageal fistula in esophageal cancer: Case report and review of the literature

pTEVAR of an aorto-esophageal fistula in esophageal cancer: Case report and review of the literature

An aorto-esophageal fistula (AEF) is a rare and life-threatening situation, associated with aneurysms, foreign bodies, infiltrating tumors, and radiotherapy. The ideal management is unclear. Open surgery of AEF has a high mortality and morbidity. Thoracic endovascular aortic repair (TEVAR) of an AEF...

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Bibliographic Details
Main Authors: Owczarek, Andreas D., Viniol, Simon, König, Alexander M., Görlach, Jannis, Denzer, Ulrike W., Stathopoulos, Petros, Mahnken, Andreas H.
Format: Article
Language:English
Published: Philipps-Universität Marburg 2023
Subjects:
Medizin
Gastrointestinal bleeding, Esophageal cancer, Aorto-esophageal fistula, Percutaneous thoracic endovascular repair, Endovascular treatment
Medical sciences Medicine
Online Access:PDF Full Text
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Summary:An aorto-esophageal fistula (AEF) is a rare and life-threatening situation, associated with aneurysms, foreign bodies, infiltrating tumors, and radiotherapy. The ideal management is unclear. Open surgery of AEF has a high mortality and morbidity. Thoracic endovascular aortic repair (TEVAR) of an AEF is an effective and safe emergency treatment for these patients. We describe a case of AEF due to esophageal cancer successfully treated the first time by total percutaneous TEVAR (pTEVAR). A 70-year-old male patient presented with massive hematemesis at the emergency department. The patient had a known history of esophageal cancer previously treated by radiochemotherapy which was completed 3 days before. Emergency upper gastrointestinal endoscopy failed to stop the bleeding. Subsequent contrast-enhanced computed tomography revealed an aorto-esophageal fistula and emergency pTEVAR was performed. The bleeding stopped directly after stent graft placement and the patient was discharged after 10 days later. He died 3 months after pTEVAR from cancer progression. pTEVAR is an effective and safe treatment option for AEF. It can be applied as a first-line treatment and offers the potential to improve survival in the emergency setting.
Item Description:Gefördert durch den Open-Access-Publikationsfonds der UB Marburg.
DOI:10.1016/j.radcr.2023.04.037

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