Endovascular treatment of aortoesophageal and aortobronchial fistulae

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Even when promptly recognized and treated, aortoesophageal (AEF) and aortobronchial (ABF) fistulae are highly lethal conditions. Open surgical repair also carries a high risk of mortality and morbidity. Several alternative strategies have been recently reported in the literature including thoracic endovascular aortic repair (TEVAR). However, relatively little is known about results of TEVAR for AEF and ABF due to their rarity and the lack of large surveys. Methods: A voluntary national survey was conducted among Italian universities and hospital centers with an endovascular program. Questionnaires were distributed by e-mail to participating centers and aimed to evaluate the results of endovascular repair of established AEF or ABF. Results: Seventeen centers agreed to participate and provided data on their patients. Between 1998 and 2008, a total of 1138 patients were treated with TEVAR. In 25 patients (2.2%), the indication to treatment was an AEF and/or an ABF. In 10 of these cases (40%), an associated open surgical procedure was also performed. Thirty-day mortality rate of AEF/ABF endovascular repair was 28% (7 cases). No cases of paraplegia or stroke were observed. Mean follow-up was 22.6 months (range, 1-62). Actuarial survival at 2 years was 55%. Among the 18 initial survivors, five patients (28%) underwent reintervention due to late TEVAR failure. Conclusions: Stent grafting for AEF and ABF represents a viable option in emergent and urgent settings. However, further esophageal or bronchial repair is necessary in most cases. Despite less invasive attempts, mortality associated with these conditions remains very high.

Original languageEnglish
Pages (from-to)1195-1202
Number of pages8
JournalJournal of Vascular Surgery
Volume51
Issue number5
DOIs
Publication statusPublished - May 2010

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Fistula
Thorax
Mortality
Therapeutics
Paraplegia
Postal Service
Stents
Survivors
allogenic effect factor
Stroke
Morbidity
Survival
Surveys and Questionnaires

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Endovascular treatment of aortoesophageal and aortobronchial fistulae. / Chiesa, Roberto; Melissano, Germano; Marone, Enrico M.; Kahlberg, Andrea; Marrocco-Trischitta, Massimiliano M.; Tshomba, Yamume.

In: Journal of Vascular Surgery, Vol. 51, No. 5, 05.2010, p. 1195-1202.

Research output: Contribution to journalArticle

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