Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula
Aneurysms of aortic arch are rare but amenable to endovascular therapy. Arch aneurysm presenting with aorto-esophageal fistula and hematemesis is a feared, but relatively rare complication. The extrapolation of the safety and rapidity of emergent endovascular repair for bleeding arch aneurysms has b...
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doaj-e78fdbf70e1140018528305881ac660d2020-11-25T00:55:03ZengElsevierIndian Heart Journal0019-48322015-12-0167S3S60S6310.1016/j.ihj.2015.11.016Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistulaRam Das Nayak0Mathews Paul1George Jose Valooran2Rosh Varghese3Senior Consultant and Head, Department of Cardiology, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, IndiaConsultant, Department of Cardiology, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, IndiaConsultant, Department of Cardiothoracic and Vascular Surgery, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, IndiaConsultant, Department of Gastroenterology, Rajagiri Hospital, Chunangamvely, Aluva, Kochi, Kerala 683112, IndiaAneurysms of aortic arch are rare but amenable to endovascular therapy. Arch aneurysm presenting with aorto-esophageal fistula and hematemesis is a feared, but relatively rare complication. The extrapolation of the safety and rapidity of emergent endovascular repair for bleeding arch aneurysms has been infrequently reported. A bovine arch anatomy confers distinct advantages for endovascular therapy often avoiding a preceding debranching surgery. However, its endovascular treatment might be complicated by the nonhealing of fistula and potential risk for mediastinitis. Here, we report a case of a bovine aortic arch cystic aneurysm complicated by bleeding aorto-esophageal fistula, which warranted an emergent endovascular therapy. The prevertebral part of LSCA was plugged to interrupt the retrograde filling and a future endoleak. A nonhealing aorto-mediastinal fistula at follow-up was successfully treated by covered esophageal stenting. This report reiterates the importance of multidisciplinary approach with multispecialty collaboration to such complex spectrum of diseases.http://www.sciencedirect.com/science/article/pii/S0019483215008482Endovascular stentArch aneurysmAorto-esophageal fistulaEsophageal stent |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ram Das Nayak Mathews Paul George Jose Valooran Rosh Varghese |
spellingShingle |
Ram Das Nayak Mathews Paul George Jose Valooran Rosh Varghese Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula Indian Heart Journal Endovascular stent Arch aneurysm Aorto-esophageal fistula Esophageal stent |
author_facet |
Ram Das Nayak Mathews Paul George Jose Valooran Rosh Varghese |
author_sort |
Ram Das Nayak |
title |
Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula |
title_short |
Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula |
title_full |
Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula |
title_fullStr |
Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula |
title_full_unstemmed |
Emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula |
title_sort |
emergent endovascular stent grafting for saccular arch aneurysm complicated by aorto-esophageal fistula |
publisher |
Elsevier |
series |
Indian Heart Journal |
issn |
0019-4832 |
publishDate |
2015-12-01 |
description |
Aneurysms of aortic arch are rare but amenable to endovascular therapy. Arch aneurysm presenting with aorto-esophageal fistula and hematemesis is a feared, but relatively rare complication. The extrapolation of the safety and rapidity of emergent endovascular repair for bleeding arch aneurysms has been infrequently reported. A bovine arch anatomy confers distinct advantages for endovascular therapy often avoiding a preceding debranching surgery. However, its endovascular treatment might be complicated by the nonhealing of fistula and potential risk for mediastinitis. Here, we report a case of a bovine aortic arch cystic aneurysm complicated by bleeding aorto-esophageal fistula, which warranted an emergent endovascular therapy. The prevertebral part of LSCA was plugged to interrupt the retrograde filling and a future endoleak. A nonhealing aorto-mediastinal fistula at follow-up was successfully treated by covered esophageal stenting. This report reiterates the importance of multidisciplinary approach with multispecialty collaboration to such complex spectrum of diseases. |
topic |
Endovascular stent Arch aneurysm Aorto-esophageal fistula Esophageal stent |
url |
http://www.sciencedirect.com/science/article/pii/S0019483215008482 |
work_keys_str_mv |
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