title: Thoracic endovascular repair for aorto-esophageal fistula in patients with esophageal carcinoma: report of 3 cases.
abstract: Aorto-esophageal fistula (AEF) is a rare complication of esophageal carcinoma. Left untreated, it may be lethal due to massive upper gastrointestinal bleeding, while open thoracic surgery is associated with high operative mortality and morbidity. In contrast, thoracic endovascular aortic repair (TEVAR) for AEF is less invasive than open thoracic surgery. Here, we report 3 successful cases of AEF with esophageal carcinoma treated using TEVAR under local anesthesia in the emergent or urgent phase. General condition of all the patients was dramatically improved, but 1 patient with exsanguinations developed infection of the implanted stent-graft and died due to sepsis. The other 2 patients were treated before esophageal bleeding and remained alive for 1 year without infection. The TEVAR should be considered as early as possible in patients with advanced esophageal carcinoma receiving radiation or chemotherapy who develop early signs of AEF such as symptoms of chest discomfort or descending aortic irregularity on computed tomography scan.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan. nobo.ishikawa@gmail.com
authors.forename: Noboru
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Kazuto
authors.initials: K
authors.lastname: Maruta
authors.forename: Masaya
authors.initials: M
authors.lastname: Oi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Iizuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawaura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Omoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D002277:Carcinoma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D057510:Endovascular Procedures; D004937:Esophageal Fistula / Q000209:etiology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000209:etiology / Q000601:surgery*