Tracheo-Bronchial Obstruction and Esophageal Perforation after TEVAR for Thoracic Aortic Rupture

Seto, Takashi; Fukui, Daisuke; Tanaka, Haruki; Komatsu, Kotaro; Ohtsu, Yoshinori; Terasaki, Takamitsu; Wada, Yuko; Tamaki, Toru; Koike, Shoichiro; Amano, Jun

doi:10.3400/avd.cr.14-00080

Cited by 10 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Watanabe et al [9] described a case of esophageal necrosis secondary to ruptured thoracic aortic aneurysm resulting in mediastinal hematoma causing compression of the esophagus. Several other case reports of esophageal necrosis have been described after thoracic endovascular aortic repair (TEVAR) due to mediastinal hematoma (Tobisch et al [10], Koizumi et al [11], Abou-Al-Shaar et al [12], Seto et al [13]). In contrast to these cases, in our case, there was no evidence of rupture of TAA or mediastinal hematoma.…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Esophageal Necrosis from Unruptured Thoracic Aortic Aneurysm

Polavarapu

Gurala

Mudduluru

et al. 2020

Case Reports in Gastrointestinal Medicine

View full text Add to dashboard Cite

Acute esophageal necrosis (AEN), also known as black esophagus due to its appearance on endoscopy, classically involves the distal esophagus (97% of cases). AEN affecting the midesophagus with sparing of the distal esophagus is rare and usually occurs in patients with thoracic aortic aneurysmal (TAA) rupture or aortic dissection. Herein, we report a unique case of AEN in the midesophagus in a patient with an unruptured and undissected TAA.

show abstract

Section: Discussionmentioning

confidence: 99%

A Case of Acute Esophageal Necrosis from Unruptured Thoracic Aortic Aneurysm

Polavarapu

Gurala

Mudduluru

et al. 2020

Case Reports in Gastrointestinal Medicine

View full text Add to dashboard Cite

show abstract

“…Delayed esophageal perforation secondary to thoracic aortic replacement or thoracic endovascular aortic repair (TEVAR) is a rare but potentially fatal condition [2, 4–7]. …”

Section: Discussionmentioning

confidence: 99%

“…Seto et al reported that although the exact mechanism of secondary esophageal perforation after stent grafting remains unknown, hypotheses include (1) direct erosion of the stent graft into the esophagus, (2) pressure necrosis caused by the self-expanding endoprosthesis, (3) ischemic esophageal necrosis due to disruption of the arteries that feed the esophagus, (4) infection of the stent-graft prosthesis (artificial graft for aortic replacement was included in our case), (5) pseudoaneurysm development, and (6) endoleakage into the residual aneurysmal sac [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Seven esophageal perforation cases after aortic replacement/stenting for thoracic aortic dissection or aneurysm

et al. 2017

View full text Add to dashboard Cite

Background: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. Case presentation: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two. We evaluated the treatment of the perforation, the cause of death, and the median survival time after reparative surgery (esophagectomy). Initial treatment of the perforation was esophagectomy without reconstruction in six and esophagogastric bypass (later, esophagectomy was performed) in one. Three of seven cases could be discharged from hospital or moved to another hospital, but two of these three cases died of major bleeding on postoperative days 320 and 645. The other four esophagectomy cases died in hospital because of sepsis on postoperative days 14, 30, and 41 and major bleeding on postoperative day 54. The one surviving case was a 65-year-old man who underwent reconstruction, and was still alive without signs of infection at 424 days postoperatively. Conclusion: The prognosis of esophageal perforation cases after aortic replacement/stenting for thoracic aortic dissection or aneurysm is poor, though there were some cases with relatively long survival. Therefore, the indication for invasive esophagectomy should be decided carefully. Control of infection including regional infection is essential for successful treatment.

show abstract

“…In such cases, the esophageal necrosis can be presented as either an aortoesophageal fistula [1][2][3] or a free esophageal perforation. [4][5][6][7] Both are extremely rare complications, and to the best of our knowledge, only 4 cases of free esophageal perforation following endovascular repair of thoracoabdominal aortic aneurysm (TAAA) have been described in the published literature, all with a fatal outcome. [4][5][6][7] Herein, we report the first case of successful management of a free esophageal perforation following emergency hybrid visceral debranching and distal endograft extension to repair a ruptured TAAA.…”

Section: Introductionmentioning

confidence: 99%

Free Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic Aneurysm

Abou‐Al‐Shaar

Zaza

Sharif

et al. 2016

Vasc Endovascular Surg

View full text Add to dashboard Cite

Free esophageal perforation following a hybrid visceral debranching and distal endograft extension to repair a ruptured thoracoabdominal aortic aneurysm (TAAA) is a rare complication. The authors report a 56-year-old male who underwent elective thoracic endovascular aortic repair of a thoracic aneurysm. Four and a half years later, he presented with a new aneurysm extending from the distal end of the thoracic stent graft to the aortic bifurcation involving all the visceral arterial branches. The TAAA ruptured while he was awaiting an elective repair, and as a result, he underwent an emergency hybrid procedure. This involved debranching the visceral arterial branches including autotransplantation of the left kidney and distal endograft extension. Postoperatively, he developed free esophageal perforation secondary to ischemic necrosis requiring esophageal resection and gastric pull-up. The patient was well 6 months after the gastrointestinal restorative procedure. Thus, esophageal perforation following an emergency hybrid repair of ruptured TAAA is a rare complication, and a successful outcome depends on early recognition and surgical exclusion of the ruptured viscus.

show abstract

Tracheo-Bronchial Obstruction and Esophageal Perforation after TEVAR for Thoracic Aortic Rupture

Cited by 10 publications

References 10 publications

A Case of Acute Esophageal Necrosis from Unruptured Thoracic Aortic Aneurysm

A Case of Acute Esophageal Necrosis from Unruptured Thoracic Aortic Aneurysm

Seven esophageal perforation cases after aortic replacement/stenting for thoracic aortic dissection or aneurysm

Free Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic Aneurysm

Contact Info

Product

Resources

About