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

Add Comment 0 Comments


01 February 2024 : Editorial  

Editorial: Global Health Concerns as Vaccine-Preventable Infections Including SARS-CoV-2 (JN.1), Influenza, Respiratory Syncytial Virus (RSV), and Measles Continue to Rise

Dinah V. Parums

DOI: 10.12659/MSM.943911

Med Sci Monit 2024; 30:e943911


In Press

05 Jan 2024 : Clinical Research  

Effectiveness of Glutamine Oral Care in Reducing Oral Mucositis and Improving Oral Health After Neurosurger...

Med Sci Monit In Press; DOI: 10.12659/MSM.942585  

02 Jan 2024 : Clinical Research  

Urinary Concentration of Renal Biomarkers in Healthy Term Neonates: Gender Differences in GST-pi Excretion

Med Sci Monit In Press; DOI: 10.12659/MSM.942819  

29 Dec 2023 : Clinical Research  

Performance of Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) in Chinese Population with Prima...

Med Sci Monit In Press; DOI: 10.12659/MSM.942747  

08 Jan 2024 : Review article  

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

Med Sci Monit In Press; DOI: 10.12659/MSM.943100  

Most Viewed Current Articles

16 May 2023 : Clinical Research  

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387


17 Jan 2024 : Review article  

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799


14 Dec 2022 : Clinical Research  

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990


01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952


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