Endovascular Repair of Aortobronchial Fistula due to Saccular Aneurysm of Thoracic Aorta

Aortobronchial fistula (ABF) is a rare condition which can be lethal if left untreated. Open surgical treatment carries high morbidity and mortality. Recent advances in endovascular technology have made thoracic endovascular aortic repair (TEVAR) the treatment of choice. We present a successful endovascular repair of aortobronchial fistula due to a saccular aneurysm of descending thoracic aorta.

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Penetrated Descending Thoracic Aorta After Blunt Chest Trauma: Successful Endovascular Repair

Journal of Trauma and Acute Care Surgery ◽

10.1097/01.ta.0000233674.90846.bf ◽

2009 ◽

Vol 66 (3) ◽

pp. E36-E38 ◽

Cited By ~ 4

Author(s):

Ian F. Faneyte ◽

J Carel Goslings ◽

Krijn P. van Lienden ◽

Mirza M. Idu

Keyword(s):

Thoracic Aorta ◽

Endovascular Repair ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Descending Thoracic Aorta

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Recurrent Aortobronchial Fistula after Endovascular Stenting for Infected Pseudoaneurysm of the Proximal Descending Thoracic Aorta: Case Report

Journal of Chest Surgery ◽

10.5090/jcs.20.138 ◽

2021 ◽

Vol 54 (5) ◽

pp. 425-428

Author(s):

Sun-Geun Lee ◽

Seung Hyong Lee ◽

Won Kyoun Park ◽

Dae Hyun Kim ◽

Jae Won Song ◽

...

Keyword(s):

Case Report ◽

Thoracic Aorta ◽

Descending Thoracic Aorta ◽

Endovascular Stenting ◽

Aortobronchial Fistula ◽

Infected Pseudoaneurysm

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Endovascular Repair for Retrograde Type A Intramural Haematoma with Intimal Tear in the Descending Thoracic Aorta

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2020.05.021 ◽

2020 ◽

Vol 60 (3) ◽

pp. 386-393 ◽

Cited By ~ 1

Author(s):

Okano Ryoi ◽

Chia-Hsun Lin ◽

Jian-Ming Chen ◽

Yung-Kun Hsieh ◽

Shoei-Shen Wang ◽

...

Keyword(s):

Thoracic Aorta ◽

Endovascular Repair ◽

Type A ◽

Intramural Haematoma ◽

Descending Thoracic Aorta ◽

Intimal Tear

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A New Methodology to Determine Apposition, Dilatation, and Position of Endografts in the Descending Thoracic Aorta After Thoracic Endovascular Aortic Repair

Journal of Endovascular Therapy ◽

10.1177/1526602819859891 ◽

2019 ◽

Vol 26 (5) ◽

pp. 679-687 ◽

Cited By ~ 1

Author(s):

Kim van Noort ◽

Richte C. L. Schuurmann ◽

Gersom Post Hospers ◽

Emma van der Weijde ◽

Hans G. Smeenk ◽

...

Keyword(s):

Aortic Aneurysm ◽

Thoracic Aorta ◽

Thoracic Aortic Aneurysm ◽

Interobserver Agreement ◽

Interobserver Variability ◽

Thoracic Endovascular Aortic Repair ◽

Descending Thoracic Aorta ◽

Applied Software ◽

Shortest Distance ◽

The Mean

Purpose: To validate computed tomography angiography (CTA)–applied software to assess apposition, dilatation, and position of endografts in the proximal and distal landing zones after thoracic endovascular aortic repair (TEVAR) of thoracic aortic aneurysm. Materials and Methods: Twenty-two patients (median age 75.5 years; 11 men) with a degenerative descending thoracic aortic aneurysm treated with TEVAR with at least one postoperative CTA were selected from a single center’s database. New CTA-applied software was used to determine the available apposition surface in the proximal and distal landing zones, apposition of the endograft fabric with the aortic wall, shortest apposition length, endograft inflow and outflow diameters, shortest distance between the left subclavian artery and the proximal endograft fabric, and shortest distance between the celiac trunk and the distal endograft fabric on each CTA. Interobserver variability for these parameters was assessed with the repeatability coefficient and the intraclass correlation coefficient. Results: Excellent interobserver agreement was found for all measurements. Interobserver variability of surface and shortest apposition length calculations was larger for the distal site compared with the proximal site, with a mean difference of 10% vs 2% of the mean available apposition surface, 12% vs 5% of the endograft apposition surface, and 16% vs 8% of the shortest apposition length, respectively. Inflow and outflow diameters of the endograft showed low variability, with a mean difference of 0.1 mm with 95% of the interobserver difference within 1.8 mm. Mean interobserver differences of the proximal and distal shortest fabric distances were 1.0 and 0.9 mm (both 2% of the mean lengths). Conclusion: Assessment of apposition, dilatation, and position of the proximal and distal parts of an endograft in the descending thoracic aorta is feasible after TEVAR with the new software. Interobserver agreement for all measured parameters was excellent for the proximal and distal landing zones. The new method allows detection of subtle changes during follow-up. However, a larger study is needed to quantify how parameters change over time in complicated and uncomplicated TEVAR cases and to define the real added value of the new methodology.

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Can the Left Subclavian Artery be Safely Covered during Endovascular Repair of the Descending Thoracic Aorta?

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31817793f8 ◽

2008 ◽

Vol 3 (3) ◽

pp. 147-150 ◽

Cited By ~ 4

Author(s):

Ourania Preventza ◽

Grayson H. Wheatley ◽

James Williams ◽

Hannan Chaugle ◽

Kakra Hughes ◽

...

Keyword(s):

Thoracic Aorta ◽

Subclavian Artery ◽

Endovascular Repair ◽

Left Subclavian Artery ◽

Left Internal Mammary Artery ◽

Artery Bypass ◽

Bypass Graft ◽

Descending Thoracic Aorta ◽

Complete Coverage ◽

Internal Mammary

Objective Routine preoperative carotid-subclavian bypass or transposition is frequently recommended in patients undergoing endovascular repair of the descending thoracic aorta (DTA). We reviewed our comprehensive thoracic endografting experience with regards to coverage of the left subclavian artery (LSA) to assess whether mandatory preoperative carotid-subclavian bypass or transposition is necessary. Methods Between February 2000 and November 2005, 255 patients were successfully treated with an endoluminal graft (ELG) to the DTA. Indications for intervention included atherosclerotic aneurysms (109/255, 42.7%), acute and chronic dissections (75/255, 29.4%), miscellaneous (41/255, 16.1%), and penetrating aortic ulcers (30/255, 11.8%). There were 151 males (151/255, 59.2%) and 104 females (104/255, 40.8%) with a mean age of 71 years (range, 23–91 years). Results The LSA was completely covered with an ELG in 71 patients (71/255, 27.8%) and partially covered in 47 patients (47/255, 18.4%). In patients who had complete coverage of the LSA, 30 patients (30/71, 42.3%) had acute or chronic Type B dissections, 26 patients (26/71, 36.6%) had aneurysms, 11 patients (11/71, 15.5%) had miscellaneous aortic pathologies, and 4 patients (4/71, 5.6%) had pseudoaneurysms associated with prior coarctation repair. Fifteen patients (15/255, 5.9%) underwent preoperative carotid-subclavian bypass or transposition and subsequently underwent complete coverage of the LSA with an ELG. One patient (1/56, 1.8%) with complete coverage of the LSA required elective postoperative carotid-subclavian bypass secondary to left arm claudication. Conclusions Routine preoperative carotid-subclavian bypass is not necessary, except in select patients with a patent left internal mammary artery to the left anterior descending artery bypass graft or contralateral vertebral artery disease.

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Quantifying Dynamics of the Ascending Thoracic Aorta in Patients With and Without Aneurysms Using 4D-CT

ASME 2008 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2008-191942 ◽

2008 ◽

Author(s):

Polina A. Segalova ◽

Tina M. Morrison ◽

Charles A. Taylor

Keyword(s):

Endovascular Treatment ◽

Thoracic Aorta ◽

Dynamic Characteristics ◽

Endovascular Repair ◽

Recovery Time ◽

Mortality Rates ◽

Lower Mortality ◽

Descending Thoracic Aorta ◽

4D Ct ◽

Challenging Environment

Endovascular repair of the thoracic aorta is becoming the preferred treatment for aneurysms due to lower mortality rates and shorter recovery time in the ICU [1]. The success of endovascular treatment greatly depends on the anatomy and dynamic characteristics of the aneurismal region, with the descending thoracic aorta (DTA) presenting a less challenging environment than the ascending thoracic aorta (ATA). As such, devices and methods for endovascular treatment of the ATA remain to be developed. In fact, there is currently no FDA-approved implantable device to treat aneurysms in the ATA.

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Lethal aorto-oesophageal fistula 16 years after aortic prosthetic reconstruction: Delayed rupture as cause of death

Medicine Science and the Law ◽

10.1177/0025802420936796 ◽

2020 ◽

pp. 002580242093679

Author(s):

Beatrice Benedetti ◽

Marica Felice ◽

Francesco Locco ◽

Paola Roberti ◽

Roberto Demontis

Keyword(s):

Vascular Surgery ◽

Thoracic Aorta ◽

Surgical Complications ◽

Rare Complication ◽

Thoracic Endovascular Aortic Repair ◽

Descending Thoracic Aorta ◽

Prosthetic Reconstruction ◽

Clinical Onset ◽

Aortic Repair ◽

One Year

The development of aorto-oesophageal fistula (AOF) is a rare complication following thoracic aortic repair. Mortality is high, in most cases due to fatal haematemesis. The clinical onset is variable, occurring approximately one year after surgery. We report a case of a lethal AOF in a 58-year-old man. He underwent open vascular surgery 16 years prior to his death due to a rupture of the descending thoracic aorta. In the early 2000s, the open vascular approach was replaced by thoracic endovascular aortic repair. As a result of this approach, the number of surgical complications has reduced, with the exception of AOF.

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