title: Strategies for endovascular aortic repair in aortobronchial and aortoesophageal fistulas.
abstract: OBJECTIVE
  To report our experience of thoracic endovascular aortic repair (TEVAR) for acute bleeding originating from the thoracic aorta in patients with aortobronchial fistula (ABF) or aortoesophageal fistula (AEF).
  
  
  METHODS
  A total of nine patients (three woman) were treated from September 1995 to March 2012 by TEVAR for ABF (n = 5) and AEF (n = 4). The implants (N = 14) were introduced with fluoroscopic guidance via the aorta (n = 1), the iliac (n = 2), or femoral (n = 11) artery, respectively.
  
  
  RESULTS
  All aortic lesions could be sealed successfully. Perioperative morbidity was 0% in the ABF group and 50% (2 of 4) in the AEF group and no procedure-related morbidity was noted except one patient who received aortofemoral reconstruction because of iliac occlusive disease. After an overall mean follow-up of 56 months, three patients of the ABF group are alive and well and two patients died of nonrelated cause. Of the AEF group, one patient is alive after 22 months, and one died from metastasized esophageal cancer after 7 months.
  
  
  CONCLUSIONS
  TEVAR is a safe and reliable procedure in the management of ABF. For AEF, TEVAR provides a successful first-line treatment to seal the fistula and control bleeding. However, prognosis is limited by the esophageal lesion and by ongoing mediastinitis/sepsis.
authors.affiliation: Division of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, University Medical Center, Johannes-Gutenberg University, Mainz, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Dorweiler
authors.forename: Ernst
authors.initials: E
authors.lastname: Weigang
authors.forename: Friedrich
authors.initials: F
authors.lastname: Duenschede
authors.forename: Michael Bernhard
authors.initials: MB
authors.lastname: Pitton
authors.forename: Christoph
authors.initials: C
authors.lastname: Dueber
authors.forename: Christian-Friedrich
authors.initials: CF
authors.lastname: Vahl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D001983:Bronchial Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects; D004937:Esophageal Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery*