Endovascular Treatment of an Aortobronchial Fistula

Abstract

A 67-year-old man operated on 8 years previously for type B aortic dissection presented with two episodes of massive hemoptysis. An aortobronchial fistula was suspected with spiral computed tomography angiography, and showed a small pseudoaneurysm corresponding to the distal anastomotic site. The patient underwent endovascular stent-graft implantation and is asymptomatic 8 months after the procedure.

Thoracic endovascular repair as a safe management strategy for aortobronchial fistulas

“…The characteristics and diagnostic workup of our patients mirror those reported in similar case reports and meta-analyses. [24][25][26][27][28][29][30][31][32][33][34] Notably, our treatment group had a nearly even distribution of men and women, all patients presented with hemoptysis, and each received a CT as part of the initial diagnostic work-up. Though CTA was successful in demonstrating thoracic aortic pathology and adjacent lung parenchymal changes, no ABF were visualized as a direct result of this diagnostic test.…”

Stent-Graft Repair of Aortobronchial Fistula: A Review

“…From the 44 retrieved articles, 30 were case reports providing data on a total of 57 cases of ABF (Table 2). 17–46 The remaining 14 articles, for a total of 25 ABFs, were found within published series of aortic stent-graft cases for acute emergent aortic ruptures in the airways (Table 3). 6,47–59…”

“…The search identified 56 potentially relevant series from 1996 to 2008. 3–6,8–59 All were nonrandomized and retrospective case reports or case series. After reviewing selected articles, 12 were excluded for the following reasons: the stent-graft was implanted before the ABF developed in 3 reports, 8–10 2 studies focused on endovascular treatment other than stent-graft, 3,4 3 cases were duplicated work from the same group of authors, 11–13 1 study did not provide specific outcomes for ABF patients, 14 and 3 reports focused on ABF surgical repair.…”

“…After reviewing selected articles, 12 were excluded for the following reasons: the stent-graft was implanted before the ABF developed in 3 reports, 8–10 2 studies focused on endovascular treatment other than stent-graft, 3,4 3 cases were duplicated work from the same group of authors, 11–13 1 study did not provide specific outcomes for ABF patients, 14 and 3 reports focused on ABF surgical repair. 5,15,16 In the remaining 44 studies, 6,17–59 a total of 82 patients received stent-grafts for ABF. Studies were separated in 2 groups: case reports focusing on ABF with more detailed information (Table 2) or ABF cases extracted from acute aortic series that included aortic ruptures into the airways (Table 3).…”

Thoracic endovascular aortic repair of aortobronchial fistulas

“…Reported outcomes after TEVAR for ABFs have been largely limited to individual case reports [4][5][6][7][8][9][10][11][12][13][14][15][16] or small case series. [17][18][19][20][21][22][23][24] To evaluate the feasibility of TEVAR for ABFs, we reviewed our single-institution case series and initiated an extensive review of the published experience to date.…”