[Endovascular managemente of an aorto-bronchial fistula secondary to a thoracic aortic aneurysm].

Abstract

OBJECTIVE:

Presentation of a case of endovascular repair of aorto-bronchial fistula secondary to thoracic aortic aneurysm.

MATERIAL AND METHODS:

67 years old male patient, former smoker, with a history of arterial hypertension, dyslipidemia, coronary artery disease, chronic renal insufficiency and carotid endarterectomy, followed in outpatient department with recent diagnosis of descending TAA. The patient presented to the emergency department due to 2 episodes of cough and self-limited abundant hemoptysis. The thoracic angio-CT revealed a rupture of the aneurysm, with 77mm, to the lung parenchyma with aorto-bronchial fistula to the left main bronchus. Patient was submitted to endovascular repair using a Valiant Thoracic endoprosthesis by Medtronic®, via right femoral approach.

RESULTS:

The procedure went without complications. There was no paraplegia or acute arterial lesion. Postoperatively, there were registed two episodes of self-limited hemoptysis and developed cough that progressively reversed after 2 months. The patient held antibiotic prophylaxis during hospitalization and for 2 months after discharge. 12 months after procedure, no complications were observed and patient remains asymptomatic.

CONCLUSION:

The advance of endovascular approach in the treatment of complicated AAT brought a new therapeutic solution, giving a reduction in morbidity and mortality (± 3%), particularly for control of active aorto-bronchial fistula. As regards to success rate and long-term antibiotic prophylaxis, present studies are inconclusive. Concerned to infection risk and fistula recurrence (± 10%), long-term antibiotic administration was the chosen treatment.

• Authors: Mário Vieira, Pedro Paz Dias, Augusto Rocha E Silva, Sérgio Sampaio, R De Albuquerque
• Journal: Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular (Rev Port Cir Cardiotorac Vasc) 2011 Jul-Sep Vol. 18 Issue 3 Pg. 173-6 ISSN: 0873-7215 [Print] Portugal
• Vernacular Title: Correcção endovascular de aneurisma da aorta torácica complicado por fístula aorto-brônquica primária.
• PMID: 23596622 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Aged
• Aortic Aneurysm, Thoracic (complications)
• Aortic Diseases (etiology, surgery)
• Bronchial Fistula (etiology, surgery)
• Endovascular Procedures
• Humans
• Male
• Vascular Fistula (etiology, surgery)