Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

01 April 2008

Aortoesophageal fistulas due to thoracic aorta aneurysm: surgical versus endovascular repair. Is there a role for combined aortic management?

Christos Prokakis, Efstratios Koletsis, Efstratios Apostolakis, Panagiotis Dedeilias, Dimitrios Dougenis

Med Sci Monit 2008; 14(4): RA48-54 :: ID: 850309


Aortoesophageal fistula (AEF) is a rare cause of gastrointestinal bleeding with high mortality. Thoracic aorta aneurysms represent the leading cause of aortoesophageal fistula. Surgery offers the only chance for cure in these patients. So far there are no clear indications on the optimal management of these patients. A review of the literature was undertaken focusing on the surgical management of thoracic aorta aneurysm-related AEFs in an attempt to clarify the indications for the surgical or endovascular treatment of this entity. Only 37 successfully treated patients were identified. Most of them underwent open surgical repair with the intent to control both hemorrhage and mediastinal contamination. Thoracic aorta replacement with a synthetic graft was used in most cases. Cryopreserved homografts, extranatomic bypass, and endovascular stent grafting were used in a small number of patients. Esophageal manipulation using various techniques was undertaken in all patients with open surgical repair of their AEF. Based on the reported results and identified limitations of each approach, the present authors advocate open surgical repair of both aneurysm and esophageal defect as the treatment of choice in all patients with AEF and signs of infection in relatively good general condition. Stent grafting is considered a valid approach only for patients who cannot tolerate open repair. A combined technique of stent grafting for immediate bleeding control followed by open surgical repair of both aneurysm, preferably using homografts, and esophageal defect are extremely promising and may represent a more valid alternative to the classical open approach in the future.

Keywords: Aortic Aneurysm, Thoracic - surgery, Angioplasty, Arteries - transplantation, Esophageal Fistula - surgery, Transplantation, Homologous



01 August 2022 : Editorial  

Editorial: Long-Term Effects of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children and the Changing Pathogenesis of Common Childhood Viruses Driven by the COVID-19 Pandemic

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.937927

Med Sci Monit 2022; 28:e937927

In Press

12 Aug 2022 : Clinical Research  

Risk Factors and Pathogen Spectrum in Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis: A S...

Med Sci Monit In Press; DOI: 10.12659/MSM.937112  

11 Aug 2022 : Meta-Analysis  

Optimal Surgical Treatment Method for Anterior Cruciate Ligament Rupture: Results from a Network Meta-Analysis

Med Sci Monit In Press; DOI: 10.12659/MSM.937118  

10 Aug 2022 : Review article  

Programmed Cell Death in Diabetic Nephropathy: A Review of Apoptosis, Autophagy, and Necroptosis

Med Sci Monit In Press; DOI: 10.12659/MSM.937766  

10 Aug 2022 : Database Analysis  

Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study ...

Med Sci Monit In Press; DOI: 10.12659/MSM.937557  

Most Viewed Current Articles

30 Dec 2021 : Clinical Research  

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...

DOI :10.12659/MSM.935379

Med Sci Monit 2021; 27:e935379

13 Nov 2021 : Clinical Research  

Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...

DOI :10.12659/MSM.932788

Med Sci Monit 2021; 27:e932788

08 Mar 2022 : Review article  

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...

DOI :10.12659/MSM.936292

Med Sci Monit 2022; 28:e936292

01 Nov 2020 : Review article  

Long-Term Respiratory and Neurological Sequelae of COVID-19

DOI :10.12659/MSM.928996

Med Sci Monit 2020; 26:e928996

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750