Unit:
Speciality Endovascular TechniquesLibrary of the School of Health Sciences
Author:
Sakellaridis Timotheos
Supervisors info:
Γερουλάκος Γεώργιος, Καθηγητής, Ιατρική, ΕΚΠΑ
Χατζηιωάννου Αχιλλέας, Καθηγητής, Ιατρική, ΕΚΠΑ
Κακίσης Ιωάννης, Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Ενδαγγειακή αντιμετώπιση αορτοβρογχικών και αορτοοισοφαγικών συριγγίων
Translated title:
Endovascular treatment of aortobronchial and aortoesophageal fistulas
Summary:
Objective: Aortobronchial and aortoesophageal fistula are rare conditions but may be lethal for the patients. Endovascular repair of the fistulas started in the 90s and stands in practice for almost twenty years. Most of the times represents the method of choice in these conditions. Concerns have been raised regarding late results of the method. The purpose of this review is to present published data of endovascular repair of aortobronchial and aortoesophageal fistulas.
Materials and Methods: A search of PUBMED database was performed using as key-words “aortobronchial fistula” & “aortobronchial fistulae” & “aortotracheal fistula” & “aortotracheal fistulae” & “aortopulmonary fistula” & “aortopulmonary fistula” & “aortoesophageal fistula” & “aortoesophageal fistulae”. All papers that published any results regarding endovascular repair of the above fistula and were in English language were selected. For processing reasons the selected papers were assigned to two groups, one group with patients who underwent thoracic endovascular aortic repair (TEVAR) for aortobronchial fistula and a second group with patients who underwent TEVAR for aortoesophageal fistula.
Results: Two hundred eighty nine (289) papers were initially identified for aortobronchial fistula and four hundred eighty two (482) papers were identified for aortoesophageal fistula. Most of the included papers were case repots or small case series. 253 patients with aortobronchial fistula and 227 patients with aortoesophageal fistula treated with TEVAR were pointed out. The main identified cause of aortobronchial fistula was previous aortic surgery and the presence of thoracic aneurysm. In the case of aortoesophageal fistula, ingestion of foreign body and esophageal disorders had a high percentage in the cause of these fistulas, along with previous aortic surgery and thoracic aneurysm. TEVAR may the definite therapy for aortobronchial fistulas, however in the cases with aortoesophageal fistula, esophageal transection or resection provides better outcome and survival rates.
Conclusions: Results between patients who underwent TEVAR for aortobronchial fistula are different compared to those aortoesophageal fistula, as also difference outcome is observed between the TEVAR group and the group that underwent open surgery. Impressively good early outcomes of TEVAR for aortic fistulas with the bronchial tree or the esophagus, define it as the potential method of choice in these patients. Further evaluation of the method is needed, with prospective studies, outcome results and definition of appropriate follow-up protocols.
Main subject category:
Health Sciences
Keywords:
Aortobronchial fistula, Aortoesophageal fistula, Endovascular treatment
Number of references:
144
