Thoracic Endovascular Aortic Repair of Esophageal Cancer-Associated Aortoesophageal Fistula: A Case Report and Literature Review

• Published in: Case reports in oncological medicine 2018, Vol.2018, p.9851397-9851397
• Main Authors: Sasaki, Akiko, Egashira, Hideto, Tokoro, Shinnosuke, Ichita, Chikamasa, Takizawa, Satoshi, Tsukiyama, Toshitaka, Ogino, Hidemitsu, Kawachi, Jun, Shimoyama, Rai, Kako, Makoto
• Format: Report
• Language: English
• ISSN: 2090-6706
• DOI: 10.1155/2018/9851397

BACKGROUNDThoracic endovascular aortic repair of an aortoesophageal fistula is an effective emergency treatment for patients with T4-esophageal cancer, as it prevents sudden death, and is a bridge to surgery. However, the course of unresectable malignant aortoesophageal fistula treated with thoracic endovascular aortic repair alone is not well-known. CASE PRESENTATIONWe report a 67-year-old Japanese man with T4-esophageal cancer who experienced a chemoradiation-induced aortoesophageal fistula and was rescued with thoracic endovascular aortic repair. He recovered after the procedure and survived for 4 additional months with management of a mycotic aneurysm and secondary aortoesophageal fistula with the exposure of the stent graft into the esophagus. Thoracic endovascular aortic repair of aortoesophageal fistula with T4-esophageal cancer extended life for nearly an average of 4 months in the reported cases. As a postoperative complication, the exposure of the stent graft into the esophagus is rare but life-threatening; the esophageal stent insertion was effective. CONCLUSIONSWith postoperative management advances, thoracic endovascular aortic repair can improve survival and increase the quality of life of patients with T4-esophageal cancer.