Aortoesophageal fistula after thoracic endovascular aortic repair and transthoracic embolization

• Published in: Journal of vascular surgery 2007-10, Vol.46 (4), p.789-791
• Main Authors: Riesenman, Paul J., MD, MS, Farber, Mark A., MD, Mauro, Matthew A., MD, Selzman, Craig H., MD, Feins, Richard H., MD
• Format: Article
• Language: English
• Subjects: Aortic Aneurysm, Thoracic - surgery; Aortic Diseases - etiology; Aortic Diseases - therapy; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis Implantation - adverse effects; Cardiology. Vascular system; Device Removal; Diseases of the aorta; Embolization, Therapeutic - adverse effects; Esophageal Fistula - etiology; Esophageal Fistula - therapy; Humans; Male; Medical sciences; Middle Aged; Paraparesis - etiology; Prosthesis-Related Infections - etiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Vascular Fistula - etiology; Vascular Fistula - therapy; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2007.05.036

Endografts are more commonly being used to treat thoracic aortic aneurysms and other vascular lesions. Endoleaks are a potential complication of this treatment modality and can be associated with aneurysmal sac expansion and rupture. This case report presents a patient who developed a type IA endoleak after endograft repair of a descending thoracic aneurysm. The endoleak was successfully treated through computed tomographic-guided transthoracic embolization, although the patient experienced lower extremity paraparesis postprocedurally. The patient’s endovascular repair was complicated by the development of an aortoesophageal fistula and endograft infection necessitating operative débridement and endograft explantation.