Carotid-Esophageal Fistula Treated By Endovascular Approach

2020 ◽  
pp. 153857442097673
Author(s):  
Camila Girardi Fachin ◽  
Zeferino Demartini ◽  
Amanda Satuti Alcure Pinto ◽  
Elis Novochadlo Klüppel ◽  
Bernardo Corrêa de Almeida Teixeira ◽  
...  
Keyword(s):  
Esophageal Fistula ◽  
Effective Option ◽  
Long Term Follow Up ◽  
Esophageal Prosthesis ◽  
Endovascular Approach ◽  
High Index Of Suspicion ◽  
Upper Gastrointestinal ◽  
Arterial Stenting

The carotid-esophageal fistula is a rare and serious complication of the metallic esophageal prosthesis. A high index of suspicion is required for early diagnosis and treatment, decreasing the morbidity and mortality rate of this severe complication. We report a case of a 4-year-old boy presenting severe upper gastrointestinal bleeding due to a carotid-esophageal fistula, secondary to deployment of an esophageal metallic prosthesis for treatment of a recurrent stenosis. The carotid pseudo-aneurism was successfully treated with stents and coils. Although endovascular treatment is a safe and effective option, arterial stenting in children needs further studies with long-term follow-up.

scholarly journals Aorto-esophageal fistula: successful open surgical management of two cases

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Siddharth Pahwa ◽  
Susmit Bhattacharya ◽  
Siddhartha Mukhopadhyay ◽  
Ashok Verma
Keyword(s):  
Surgical Management ◽  
Surgical Repair ◽  
Hemodynamic Instability ◽  
Esophageal Fistula ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Dacron Patch ◽  
Upper Gastrointestinal

Abstract An aorto-esophageal fistula (AEF) is a rare yet life-threatening cause of upper gastrointestinal bleeding. We report our experience with open surgical management of two cases of AEF. Both cases presented with almost identical presentations: hematemesis and hemodynamic instability. The aorta in the first patient was normal; the defect was small and was repaired with a Dacron patch. The second patient had an aneurysmal aorta, which was replaced with a Dacron graft. Both cases were performed under partial bypass. The esophageal rent in both patients was debrided, primarily closed and buttressed with a vascularized intercostal pedicle. Nonavailability of endovascular personnel and equipment along with hemodynamic instability of the patient influenced our surgical strategy. Long-term follow-up of these patients is necessary to analyze the outcomes of our surgical repair.

Endovascular management of intracranial blister aneurysms: spectrum and limitations of contemporary techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Ramsey Ashour ◽  
Stephen Dodson ◽  
M Ali Aziz-Sultan
Keyword(s):  
Complication Rates ◽  
Endovascular Techniques ◽  
Parent Vessel ◽  
Endovascular Interventions ◽  
Scale Scores ◽  
Long Term Follow Up ◽  
Surgical Bypass ◽  
Endovascular Approach

BackgroundIntracranial blister aneurysms are rare lesions that are notoriously more difficult to treat than typical saccular aneurysms. High complication rates associated with surgery have sparked considerable interest in endovascular techniques, though not well-studied, to treat blister aneurysms.ObjectiveTo evaluate our experience using various endovascular approaches to treat blister aneurysms.MethodsAll consecutive blister aneurysms treated using an endovascular approach by the study authors over a 3-year period were retrospectively analyzed. A literature review was also performed.ResultsNine patients with blister aneurysms underwent 11 endovascular interventions. In various combinations, stents were used in 8/11, coils in 5/11, and Onyx in 3/11 procedures. At mean angiographic follow-up of 200 days, 8/9 aneurysms were completely occluded by endovascular means alone requiring no further treatment and 1/9 aneurysms required surgical bypass/trapping after one failed surgical and two failed endovascular treatments. At mean clinical follow-up of 416 days, modified Rankin Scale scores were improved in six patients, stable in two, and worsened in one patient. One complication occurred in 11 procedures (9%), resulting in a permanent neurologic deficit. No unintended endovascular parent vessel sacrifice, intraprocedural aneurysmal ruptures, antiplatelet-related complications, post-treatment aneurysmal re-ruptures, or deaths occurred.ConclusionThis series highlights both the spectrum and limitations of endovascular techniques currently used to treat blister aneurysms, including a novel application of stent-assisted Onyx embolization. Long-term follow-up and experience in larger studies are required to better define the role of endovascular therapy in the management of these difficult lesions.

Abdominal Aortic Aneurysm Wall Stresses After Endovascular Repair

2002 ◽  
Author(s):  
Elena S. Di Martino ◽  
Michel S. Makaroun ◽  
David A. Vorp
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Careful Consideration ◽  
Aneurysm Wall ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Endovascular Approach

The early benefits of an endovascular approach to abdominal aortic aneurysm (AAA) treatment has been reported by many authors [1,2]. One of the major advantages is that endovascular repair of AAA (EVAR) as opposed to traditional open surgery, is not a major abdominal surgery. EVAR has been shown to be associated with a death rate comparable to that of surgical repair [3]. In short term follow-up, EVAR is associated with fewer complications and a more rapid recovery [2]. On the contrary very limited data is available on long term follow-up of EVAR patients. Graft-related secondary interventions affect a consistent percentage of the treated cases. The EUROSTAR study [4] recently reported 13% of reintervention in 15.4 months. Our surgical unit reported 20.6% across 48 months in a recent review of 242 cases [3]. The frequence and type of reintervention, whose principal cause is endoleak or perigraft flow, requires careful consideration.

Indications, Technique, and Complications of Balloon Tamponade for Variceal Gastrointestinal Bleeding

1992 ◽  
Vol 7 (4) ◽  
pp. 212-218 ◽  
Author(s):  
Deborah Cook ◽  
Loren Laine
Keyword(s):  
Therapeutic Endoscopy ◽  
Upper Gastrointestinal Hemorrhage ◽  
Balloon Tamponade ◽  
Different Types ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Upper Gastrointestinal ◽  
Timely Treatment

Timely treatment of bleeding esophageal varices with balloon tamponade effectively achieves initial hemostasis. However, therapeutic endoscopy and sclerotherapy in patients with acute upper gastrointestinal hemorrhage is associated with better short- and long-term follow-up. We describe the technique of esophagogastric balloon insertion, as well as principles of monitoring and maintenance. The different types of balloons for tamponade are described, as well as potential complications.

Posterior Lumbar Apophyseal Ring Fractures in Adolescents: A Report of Four Cases

2009 ◽  
Vol 17 (1) ◽  
pp. 85-89 ◽  
Author(s):  
CH Yen ◽  
SK Chan ◽  
YF Ho ◽  
KH Mak
Keyword(s):  
Slipped Capital Femoral Epiphysis ◽  
Radicular Pain ◽  
Neurological Deficits ◽  
Low Back ◽  
End Plate ◽  
Long Term Follow Up ◽  
Benign Nature ◽  
High Index Of Suspicion

Posterior lumbar apophyseal ring (PLAR) fractures are rare in adolescents. We report 4 such cases in Chinese adolescents. Two of the patients had a slipped capital femoral epiphysis; 3 of them were overweight/obese. All presented with low back pain and radicular pain. Apophyseal fractures of the upper lumbar spine usually involve the lower end plate, whereas those of the lumbar sacral spine usually involve the upper end plate. The radiological features and pathophysiology are discussed. Two of the patients were treated with laminotomy and diskectomy after conservative treatment failed. All patients had complete resolution of their neurological deficits at a mean follow-up of 2 years. Despite its benign nature, long-term follow-up is necessary to define the natural course and prognosis of the disease. A high index of suspicion is needed to diagnose these fractures in adolescents.

scholarly journals The Importance of Rockall Scoring System for Upper Gastrointestinal Bleeding in Long-Term Follow-Up

2016 ◽  
Vol 79 (3) ◽  
pp. 188-191 ◽  
Author(s):  
Mehmet Abdussamet Bozkurt ◽  
Kıvanç Derya Peker ◽  
Mustafa Gökhan Unsal ◽  
Hakan Yırgın ◽  
İzzettin Kahraman ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Scoring System ◽  
Upper Gastrointestinal Bleeding ◽  
Long Term Follow Up ◽  
Upper Gastrointestinal
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