1
|
Anastasiadou C, Trellopoulos G, Kastora S, Kakisis I, Papapetrou A, Galyfos G, Geroulakos G, Megalopoulos A. A systematic review of therapies for aortobronchial fistulae. J Vasc Surg 2021; 75:753-761.e3. [PMID: 34624495 DOI: 10.1016/j.jvs.2021.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 08/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the study was to summarize epidemiologic data about aortobronchial fistulas and compare outcomes (mortality, recurrence, re-operation) of open, staged, and endovascular repair of aortobronchial fistula. METHODS A systematic literature review was conducted to identify eligible studies published between January of 1999 and December of 2019. The Cochrane Library, PubMed and Scopus databases were used as search engines. Eligible studies included articles reporting postoperative outcomes (death/follow-up). Literature review revealed only case reports and small case series and thus, only descriptive data with data heterogeneity was available. The corresponding authors were contacted to provide additional information or outcome updates (recurrence/reoperation/death). RESULTS Overall, 214 patients (90 studies) underwent 271 procedures (including re-do procedures and staged procedures). Most of the patients were treated by endovascular means (72.42%). Open surgical repair was performed in 21.96% and staged procedures in 5.6%. Aortobronchial fistulae located most often in the descending thoracic aorta (Zone 3,4) (64,6%) and in Zone 2 (23,8%). Fourteen percent of aortobronchial fistulae developed after thoracic endovascular aneurysm repair. Recurrence or infection occurred in 20% (43 patients). Recurrences were at some extend associated with the presence of endoleak. Long-term antibiotic administration (>1 month) was instituted in 63 patients (29.4%), whilst 90 patients (42%) did not receive antibiotics beyond hospitalization. From the remaining 61, 3 received life-long antibiotics and for 58 patients data were not available. Considering outcomes, mean follow-up was 25.1 months (0-188 months) and not significantly different among treatments. LIMITATIONS Literature review has revealed only case reports and small case series and thus, only descriptive data were available. Randomized controlled trials are not available due to the rarity of the disease which significantly decreases the power of the present study. Also, this study reflects significant data heterogeneity due to the nature of the analyzed manuscripts and would benefit from large patient cohort studies which till today have not been conducted. CONCLUSION Aortobronchial fistula is a complex disease. Endoleaks may be involved in the development and in recurrence process and they should not be disregarded. Considering major outcomes (length of follow-up), the available treating strategies are equal and thus, surgeons should feel confident to apply the treatment of their choice, taking in mind their experience, patient's age, and clinical condition.
Collapse
Affiliation(s)
| | - George Trellopoulos
- Department of Vascular Surgery - General Hospital of Thessaloniki "Georgios Papanikolaou"
| | | | - Ioannis Kakisis
- Department of Vascular Surgery -"Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens
| | | | - George Galyfos
- Department of Vascular Surgery - General Hospital of Attica "KAT"
| | - George Geroulakos
- Department of Vascular Surgery -"Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Angelos Megalopoulos
- Department of Vascular Surgery - General Hospital of Thessaloniki "Georgios Papanikolaou"
| |
Collapse
|
2
|
Bazarov DV, Shestakov AL, Chyarchyan ER, Vizhigina MA, Lokshin LS, Boranov EV, Kazaryan GA, Tskhovrebov AT. [Aorto-esophago-bronchial and aorto-pulmonary fistulas in a patient with aortic aneurysm]. Khirurgiia (Mosk) 2019:101-106. [PMID: 31317948 DOI: 10.17116/hirurgia201906101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aorto-esophageal and aorto-bronchial fistulas are rare and life-threatening diseases if emergency treatment is absent. The most of publications devoted to this problem are case reports describing successful treatment of patients with aorto-esophageal and aorto-bronchial fistulas by using of endovascular or open transthoracic surgery. However, we did not find reports of several aortic fistulas in a patient after previous aortic stenting. It is presented case report of patient with aorto-esophago-bronchial and aorto-pulmonary fistulas in postoperative period after thoracic endovascular aortic repair (TEVAR).
Collapse
Affiliation(s)
- D V Bazarov
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - A L Shestakov
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - E R Chyarchyan
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - M A Vizhigina
- Petrovsky Russian Research Center for Surgery, Moscow, Russia; Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - L S Lokshin
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - E V Boranov
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - G A Kazaryan
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - A T Tskhovrebov
- Petrovsky Russian Research Center for Surgery, Moscow, Russia
| |
Collapse
|
3
|
Walgram T, Attigah N, Schwegler I, Weber M, Dzemali O, Berthold C, Wagnetz D, Carboni GL. Off-label use of thoracic aortic endovascular stent grafts to simplify difficult resections and procedures in general thoracic surgery. Interact Cardiovasc Thorac Surg 2018; 26:545-550. [PMID: 29182741 DOI: 10.1093/icvts/ivx364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/17/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Tumour infiltration, or gross infectious involvement of the thoracic aortic wall, poses a significant intraoperative risk for fatal bleeding and therefore could compromise adequate resection or efficient surgical management of pleural infection in a considerable amount of cases. We present 3 successful cases of off-label thoracic aortic endografting to safeguard thoracic aortic wall integrity. METHODS After all patients received thoracic stent grafts through femoral access into the descending aorta, the first patient underwent a resection of a locally advanced squamous cell carcinoma of the left inferior lobe cT4cN0-1cM0 after neoadjuvant chemoradiation, which had infiltrated the descending aortic wall. The second case was video-assisted thoracoscopic bilateral pleural decortication for empyema with aortic ulcers of the distal thoracic aorta in a patient with pancreatic intrathoracic fistula in a necrotizing pancreatitis. The third patient was operated for a locally advanced squamous cell carcinoma of the left inferior lobe initial stage cT4 cN1-2 cM0 after neoadjuvant chemoradiation, which had broad contact to the descending aorta at the level of thoracic vertebrae 7 and 8 on a circumference of circa 180°. Regional ethics committee approval according the Swiss Federal Human Research Act was obtained according to regulations. RESULTS Preventive stent graft placement resulted in complication-free resection and significantly minimized the risk of fatal intraoperative bleeding. Patients were thus not exposed to complications associated with aortic cross-clamping, possible prosthetic replacement and extracorporeal circulation techniques. CONCLUSIONS In carefully selected patient populations, the resection of locally advanced tumours or infectious processes involving the aortic wall can be facilitated by thoracic endovascular aortic repair prior to resection.
Collapse
Affiliation(s)
- Tanja Walgram
- Division of Thoracic Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| | - Nicolas Attigah
- Division of Vascular Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| | - Igor Schwegler
- Division of Vascular Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| | - Markus Weber
- Division of Visceral Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| | - Omer Dzemali
- Division of Cardiac Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| | - Christian Berthold
- Division of Interventional Radiology, Department of Radiology, Triemli Hospital Zurich, Switzerland
| | - Dirk Wagnetz
- Division of Thoracic Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| | - Giovanni L Carboni
- Division of Thoracic Surgery, Department of Surgery, Triemli Hospital Zurich, Switzerland
| |
Collapse
|
4
|
Bos WTGJ, Verhoeven ELG, Zeebregts CJAM, Tielliu IFJ, Prins TR, Oranen BI, van den Dungen JJAM. Emergency Endovascular Stent Grafting for Thoracic Aortic Pathology. Vascular 2016; 15:12-7. [PMID: 17382049 DOI: 10.2310/6670.2007.00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Our aim was to report single-center results of emergency endovascular treatment for thoracic aortic disease. From March 1998 to January 2006, 30 acute thoracic EVAR procedures were carried out in 29 patients. One patient received two procedures in different settings. Four patients died before treatment could be initiated. The pathology of aortic lesions included atherosclerotic aneurysm ( n = 13), pseudoaneurysm ( n = 6), aortic rupture ( n = 5), type B dissection ( n = 5), aortobronchial or aortoesophageal fistula ( n = 4), and intramural hematoma ( n = 1). The surgical mortality rate was 21%. Three patients died as a result of technical complications, and three patients died after technically successful procedures. The mean follow-up was 31 ± 23 months. The late mortality rate was 40% (8 of 20). Four patients died of causes unrelated to the procedure; two patients died at home without autopsy. Two patients died as a consequence of graft infections. Three late nonfatal complications occurred. Two of these resulted in additional treatment: one patient developed a mycotic aneurysm that was treated with additional stent grafting, and one patient developed a type 3 endoleak after 6 years of follow-up and was successfully treated with a bridging stent graft. Endovascular treatment for acute thoracic disease is feasible and associated with a reasonable outcome. In selected cases, it may be considered as a first option.
Collapse
Affiliation(s)
- Wendy T G J Bos
- Department of Surgery, University Medical Center Groningen, 9700 RB Groningen, the Netherlands.
| | | | | | | | | | | | | |
Collapse
|
5
|
Voulalas G, Makris S, Papacharalampous G, Maltezos C. Mycotic Aneurysm Due to Leclercia Adecarboxylata: A Complication of Vertebral Osteomyelitis. Ann Vasc Surg 2016; 33:229.e1-5. [DOI: 10.1016/j.avsg.2015.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/14/2015] [Accepted: 11/08/2015] [Indexed: 12/12/2022]
|
6
|
Predictors of outcome and different management of aortobronchial and aortoesophageal fistulas. J Thorac Cardiovasc Surg 2014; 148:3020-6.e1-2. [DOI: 10.1016/j.jtcvs.2014.05.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 04/14/2014] [Accepted: 05/16/2014] [Indexed: 12/13/2022]
|
7
|
Geisbüsch P, Hoffmann S, Kotelis D, Able T, Hyhlik-Dürr A, Böckler D. Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease. J Vasc Surg 2011; 53:1528-33. [DOI: 10.1016/j.jvs.2011.01.066] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/15/2011] [Accepted: 01/21/2011] [Indexed: 11/25/2022]
|
8
|
Bailey CJ, Force S, Milner R, Kasirajan K, Veeraswamy RK. Thoracic endovascular repair as a safe management strategy for aortobronchial fistulas. J Vasc Surg 2011; 53:1202-9; discussion 1209. [DOI: 10.1016/j.jvs.2010.10.103] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 10/13/2010] [Accepted: 10/16/2010] [Indexed: 11/16/2022]
|
9
|
Thoracic aortic endovascular repair for mycotic aneurysms and fistulas. J Vasc Surg 2010; 52:37S-40S. [DOI: 10.1016/j.jvs.2010.06.139] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 06/15/2010] [Accepted: 06/17/2010] [Indexed: 11/18/2022]
|
10
|
Two-Stage Safe Repair of Aortobronchial Fistula. Ann Thorac Surg 2010; 89:275-7. [DOI: 10.1016/j.athoracsur.2009.06.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 04/29/2009] [Accepted: 06/04/2009] [Indexed: 11/15/2022]
|
11
|
De Rango P, Estrera AL, Azizzadeh A, Safi HJ. Stent-Graft Repair of Aortobronchial Fistula: A Review. J Endovasc Ther 2009; 16:721-32. [DOI: 10.1583/09-2800.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Verhoeven EL, Vourliotakis G. Thoracic endovascular aortic repair for aortobronchial or aortoesophageal fistulas: permanent or temporary salvage or not an option at all? J Endovasc Ther 2009; 16:441-2. [PMID: 19702347 DOI: 10.1583/09-2741c.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
13
|
Jonker FHW, Schlösser FJV, Moll FL, van Herwaarden JA, Indes JE, Verhagen HJM, Muhs BE. Outcomes of thoracic endovascular aortic repair for aortobronchial and aortoesophageal fistulas. J Endovasc Ther 2009; 16:428-40. [PMID: 19702348 DOI: 10.1583/09-2741r.1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify in-hospital and follow-up outcomes of thoracic endovascular aortic repair (TEVAR) for aortobronchial fistula (ABF) and aortoesophageal fistula (AEF). METHODS The authors reviewed all published cases of ABF and AEF undergoing TEVAR indexed in the MEDLINE, Cochrane Library CENTRAL, and EMBASE databases. After removal of duplicates, 850 articles were scrutinized for relevance and validity. Exclusion criteria included: (1) no clear description of the organs involved with the fistula, (2) no description of outcomes after TEVAR for ABF or AEF, or (3) no original data presented in the article. In this manner, 66 relevant articles were identified that included original data on 114 patients (76 men; mean age 63+/-1.5 years) with ABF (n = 71) or AEF (n = 43). Meta-analyses were performed to investigate outcomes of TEVAR for ABF and AEF. RESULTS Patients with AEF presented more frequently with hypovolemic shock (33% versus 13%, p = 0.012) and systemic infection (36% versus 9%, p<0.001) compared to patients with ABF. In-hospital mortality was 3% (n = 2) after TEVAR for ABF and 19% (n = 8) after TEVAR for AEF (p = 0.004). Additional thoracic surgery in the first 30 days after TEVAR was performed in 3% (n = 2) of ABF patients and in 37% (n = 16) of AEF patients (p<0.001); 12 AEF patients who had received esophageal surgery in the first month after TEVAR showed lower fistula-related mortality during 6 months of follow-up compared to patients who did not receive additional esophageal surgery (p = 0.018). CONCLUSION TEVAR is associated with superior outcomes in patients with ABF. Endovascular management of AEF is associated with poor results and should not be considered definitive treatment. TEVAR could serve as a bridge to surgery for emergency cases of AEF only, with definitive open surgical correction of the fistula undertaken as soon as possible.
Collapse
Affiliation(s)
- Frederik H W Jonker
- Department of Surgery and Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | | | | | | | | |
Collapse
|
14
|
Riesenman PJ, Brooks JD, Farber MA. Thoracic endovascular aortic repair of aortobronchial fistulas. J Vasc Surg 2009; 50:992-8. [DOI: 10.1016/j.jvs.2009.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 03/05/2009] [Accepted: 03/06/2009] [Indexed: 11/27/2022]
|
15
|
Jonker FHW, Heijmen R, Trimarchi S, Verhagen HJM, Moll FL, Muhs BE. Acute management of aortobronchial and aortoesophageal fistulas using thoracic endovascular aortic repair. J Vasc Surg 2009; 50:999-1004. [PMID: 19481408 DOI: 10.1016/j.jvs.2009.04.043] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 04/10/2009] [Accepted: 04/17/2009] [Indexed: 11/16/2022]
Affiliation(s)
- Frederik H W Jonker
- Section of Vascular Surgery, Department of Surgery at Yale University School of Medicine, New Haven, CT 06510, USA
| | | | | | | | | | | |
Collapse
|
16
|
|
17
|
Hyhlik-Dürr A, Geisbüsch P, von Tengg-Kobligk H, Klemm K, Böckler D. Intentional Overstenting of the Celiac Trunk During Thoracic Endovascular Aortic Repair: Preoperative Role of Multislice CT Angiography. J Endovasc Ther 2009; 16:48-54. [DOI: 10.1583/08-2549.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
18
|
Attigah N, Herpel E, Kotelis D, Hyhlik-Dürr A, Böckler D. Endovaskuläre Therapie einer aspergilloseinduzierten septischen Arrosionsblutung der A. subclavia. Chirurg 2008; 79:984-7. [DOI: 10.1007/s00104-008-1531-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
19
|
Wheatley GH, Nunez A, Preventza O, Ramaiah VG, Rodriguez-Lopez JA, Williams J, Olsen D, Diethrich EB. Have we gone too far? Endovascular stent-graft repair of aortobronchial fistulas. J Thorac Cardiovasc Surg 2007; 133:1277-85. [PMID: 17467441 DOI: 10.1016/j.jtcvs.2006.11.066] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 10/27/2006] [Accepted: 11/06/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Although endovascular repair of the descending thoracic aorta has emerged as a viable treatment option, little is known about its potential to treat patients diagnosed with aortobronchial fistulas. We reviewed our comprehensive thoracic endografting experience with regard to the endovascular management and subsequent outcome of patients with aortobronchial fistulas to assess whether endoluminal graft repair is a realistic option. METHODS Between February 2000 and November 2005, 255 patients were successfully treated with an endoluminal graft to the descending thoracic aorta. Indications for intervention included: atherosclerotic aneurysms (109/255, 42.7%), acute and chronic dissections (75/255, 29.4%), miscellaneous (34/255, 13.3%), penetrating aortic ulcers (30/255, 11.8%), and aortobronchial fistulas (7/255, 2.7%). RESULTS Average patient age was 73.4 +/- 10.1 years, with 4 male patients (4/7, 57.1%) and 3 female patients (3/7, 42.9%). All patients presented with hemoptysis, with 1 patient (1/7, 14.3%) requiring preoperative blood transfusion. Three patients (3/7, 42.9%) were diagnosed with atherosclerotic aneurysms, 3 patients (3/7, 42.9%) had pseudoaneurysms associated with prior open surgical repair, and 1 patient (1/7, 14.3%) had a prior endoluminal graft placed for a traumatic aortic transection. No standard postoperative antibiotic regimen was followed. There were no endoleaks, no incidences of paraplegia, and no endoluminal graft infections. Survival was 100% (7/7) at both 30 days and 1 year, and all patients are currently alive. Follow-up computed tomography was available for all 7 patients, with an average follow-up of 42.6 +/- 28.5 months. CONCLUSIONS Endovascular management of aortobronchial fistulas appears to be safe and well tolerated, even in surgically high-risk patients, with minimal risk of prosthesis infection. Long-term surveillance and continued investigation are warranted.
Collapse
Affiliation(s)
- Grayson H Wheatley
- Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix, Ariz 85006, USA.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Kaw LL, Owens EL, Kansal N. Endovascular Repair of an Aortopulmonary Fistula via the Axillary Artery. Ann Vasc Surg 2005; 19:487-91. [PMID: 15981126 DOI: 10.1007/s10016-005-4641-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A 62-year-old man presented with several months of progressive hemoptysis. He has a history of aortobifemoral bypass and thoracofemoral bypass grafts, which were both removed due to infection. Evaluation with multiple imaging modalities revealed a descending thoracic aortic pseudoaneurysm around the retained Dacrontrade mark graft with bronchiectatic changes and consolidation of the adjacent left lower lobe. No evidence of direct arterial communication between the aorta and the bronchioles was ever demonstrated, but an aortopulmonary fistula was suspected. Endovascular repair with several Excluder aortic cuffs stacked in the thoracic aorta was successfully performed via the axillary artery. Exclusion of the pseudoaneurysm with no evidence of endoleak was noted on computed tomography 2 months postoperatively, at which time the patient reported complete resolution of his hemoptysis. To our knowledge, this is the first report of endovascular repair of an aortopulmonary fistula via the axillary artery.
Collapse
Affiliation(s)
- Leoncio L Kaw
- Division of Cardiothoracic and Vascular Surgery, Scripps Clinic/Scripps Green Hospital, San Diego, CA, USA
| | | | | |
Collapse
|
21
|
López-Benítez R, Richter GM, Luburic A, Böckler D, Kauffmann G, Hallscheidt PJ. False lumen embolization for type B dissection complicated by hemoptysis. Eur J Vasc Endovasc Surg 2005; 30:370-5. [PMID: 15975835 DOI: 10.1016/j.ejvs.2005.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2004] [Accepted: 04/18/2005] [Indexed: 10/25/2022]
Abstract
In this report, we describe successful treatment of a patient with hemoptysis by false lumen embolization of a type B aortic dissection.
Collapse
Affiliation(s)
- R López-Benítez
- Department of Radiology, Heidelberg University Klinikum, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | | | | | | | | | | |
Collapse
|
22
|
Endovascular Stent-graft Repair of an Aortobronchial Fistula: Case Report and Review of the Literature. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.ejvsextra.2005.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
23
|
Böckler D, von Tengg-Kobligk H, Schumacher H, Ockert S, Schwarzbach M, Allenberg JR. Late Surgical Conversion After Thoracic Endograft Failure due to Fracture of the Longitudinal Support Wire. J Endovasc Ther 2005; 12:98-102. [PMID: 15683278 DOI: 10.1583/04-1328.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To report complications from a thoracic endograft wire fracture and early experience with elective conversion after thoracic endografting. CASE REPORT A 43-year-old man underwent urgent endovascular repair of a symptomatic post-traumatic thoracic aneurysm in 1999. The patient had been involved in a car accident 14 years before. He developed clinical and radiological signs of graft infection 46 months after stent-graft implantation. Multidetector computed tomography confirmed a fracture of the longitudinal support wire in the Excluder thoracic stent-graft. Additionally, radiological signs of suspected endograft infection were described. Due to concerns over a potential chronic infection, the stent-graft was successfully excised, and a polyester graft was implanted 50 months after primary endovascular repair. CONCLUSIONS Recognition or strong suspicion of endograft infection requires conversion with removal of the device. Long-term follow-up after endografting is necessary to assess material fatigue that undermines the durability of these implants.
Collapse
Affiliation(s)
- Dittmar Böckler
- Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Germany.
| | | | | | | | | | | |
Collapse
|