Journal Article10.4261/1305-3825.DIR.5912-12.1
Secondary aortoesophageal fistula after thoracic endovascular aortic repair for a huge aneurysm.
Akhmadu Muradi,Masato Yamaguchi,Atsushi Kitagawa,Yoshikatsu Nomura,Takuya Okada,Yutaka Okita,Koji Sugimoto +6 more
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TL;DR: The case of secondary aortoesophageal fistula four months after the procedure for a huge descending thoracic aortic aneurysm is reported, which presented with new-onset high-grade fever accompanied by elevated inflammatory markers.
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Abstract: Thoracic endovascular aortic repair for a descending thoracic aortic aneurysm is an excellent alternative to open surgery, especially in patients with a number of comorbidities. It may cause fatal complications, including aortoesophageal fistula, but these are very rare. Here, we report the case of secondary aortoesophageal fistula four months after the procedure for a huge descending thoracic aortic aneurysm, which presented with new-onset high-grade fever accompanied by elevated inflammatory markers.
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Citations
A systematic review of infected descending thoracic aortic grafts and endografts
Andrea Kahlberg,Alessandro Grandi,Diletta Loschi,Frank Vermassen,Nathalie Moreels,Nabil Chakfe,Germano Melissano,Roberto Chiesa +7 more
TL;DR: Thoracic aortic EG infection is likely to occur more frequently in association with aortoesophageal fistulas and in a shorter time compared with SG infection, and surgical treatment with graft explantation seems to be the preferable choice in fit patients.
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Comparison of treatment strategies for thoracic endograft infection
Konstantinos G. Moulakakis,Spyridon N. Mylonas,Constantine N. Antonopoulos,John D. Kakisis,George S. Sfyroeras,George Mantas,Christos D. Liapis +6 more
TL;DR: Endograft preservation seems not a durable option, and antibiotic therapy followed by drainage and repair of the fistula may control the sepsis, providing, however, mainly a temporary benefit.
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Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature.
TL;DR: 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, which is uncontrollable with anti-biotic administration.
•Journal Article
Secondary aortoesophageal fistula after thoracic aortic aneurysm endovascular repair: literature review and new insights regarding the hypothesized mechanisms
TL;DR: Selecting flexibility and appropriate size stent graft, avoiding the thin aortic wall, and identifying the risk factors may reduce the morbidity of complications with aortoesophageal fistula after thoracic aortsic aneurysm endovascular repair.
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Successful surgical treatment of aortoesophageal fistula after emergency thoracic endovascular aortic repair: aggressive débridement including esophageal resection and extended aortic replacement.
TL;DR: From 2006 to 2012, this technique was used in 15 patients, mean age 72 years, 67% female, and there were no strokes, but there were 3 in-hospital deaths, none directly related to the operative technique.
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References
Aorto-oesophageal and aortobronchial fistulae following thoracic endovascular aortic repair: a national survey.
Roberto Chiesa,Germano Melissano,Enrico Maria Marone,Massimiliano M. Marrocco-Trischitta,Andrea Kahlberg +4 more
TL;DR: The incidence of aorto-oesophageal (AEF) and aortobronchial (ABF) fistulae after thoracic endovascular aortic repair (TEVAR) is not negligible, and is comparable to that following open repair.
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Aortoesophageal Fistula Secondary to Stent-Graft Repair of the Thoracic Aorta
Holger Eggebrecht,Dietrich Baumgart,Klaus Radecke,Clemens von Birgelen,Ulrich Treichel,Ulf Herold,Peter Hunold,Guido Gerken,Heinz Jakob,Raimund Erbel +9 more
TL;DR: Aortoesophageal fistula is, in the authors' experience, a catastrophic complication of endovascular stent-graft placement and treatment options are very limited, as these patients are usually not candidates for open surgery.
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Secondary surgical procedures after endovascular stent grafting of the thoracic aorta: Successful approaches to a challenging clinical problem
Evaldas Girdauskas,Volkmar Falk,Thomas Kuntze,Michael A. Borger,Andrej Schmidt,Dierk Scheinert,Friedrich W. Mohr +6 more
TL;DR: Secondary surgical procedures after stent implantation of the thoracic aorta can be performed with very good results, despite the challenging clinical scenarios.
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Secondary aortoesophageal fistula after endoluminal exclusion because of thoracic aortic transection.
TL;DR: A 24-year-old woman has massive upper gastrointestinal tract bleeding 15 months after endoluminal stent graft placement because of traumatic descending thoracic aortic transection and the patient is well 15 years after open repair of the AEF.
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Successful Treatment of an Aortoesophageal Fistula After Emergency Endovascular Thoracic Aortic Stent-Graft Placement
Martin Czerny,Daniel Zimpfer,Tatjana Fleck,Roman Gottardi,Manfred Cejna,Maria Schoder,Johannes Lammer,Ernst Wolner,Martin Grabenwöger,M.R. Mueller +9 more
TL;DR: The case of a 57-year-old man who underwent emergency stent-graft placement in August 2003 due to a contained rupture of a distal descending aortic aneurysm, who is still being treated with antibiotic therapy of ciprofloxacin for a minimum of 1 year.
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