Elsevier

Annals of Vascular Surgery

Volume 24, Issue 4, May 2010, Pages 555.e1-555.e5
Annals of Vascular Surgery

Case Report Abstract
Aortoesophageal Fistula Secondary to Placement of an Esophageal Stent: Emergent Treatment with Cyanoacrylate and Endovascular Stent Graft

https://doi.org/10.1016/j.avsg.2009.12.009Get rights and content

We report on N-butyl 2-cyanoacrylate embolization and subsequent endovascular stent graft placement for the treatment of an aortoesophageal fistula secondary to placement of an esophageal stent. A 53-year-old man with lung cancer was admitted with massive hematemesis due to the formation of an aortoesophageal fistula 20 days after esophageal stent placement. Injection of N-butyl 2-cyanoacrylate into the aortoesophageal fistula was performed as emergent treatment for this hemodynamically unstable condition, and an endovascular stent graft was subsequently placed via the right femoral artery. The patient was well without hematemesis until he died of pneumonia 45 days later. Cyanoacrylate embolization and subsequent endovascular stent graft placement for the treatment of massive hemorrhage caused by an aortoesophageal fistula is a prompt, effective method and can be an alternative to surgical repair.

Section snippets

Case Report

A 53-year-old man with lung cancer was admitted with dysphagia. He had undergone radiation and chemotherapy 8 months earlier. Endoscopy revealed extrinsic esophageal compression, and metastatic lymphadenopathy compressing the esophagus and left atrium was observed on computed tomography (CT) scanning. An 18-mm-diameter, 10-cm-long, retrievable covered esophageal stent (CHOOSTENT; M.I. Tech, Seoul, Korea) (Fig. 1A) was placed in the mid-esophagus by an endoscopist.

The patient was admitted with

Discussion

An AEF is a life-threatening condition due to massive bleeding, and it requires prompt recognition and management. An AEF is usually caused by descending thoracic aortic diseases, including aneurysm, foreign body ingestion, and esophageal diseases such as esophageal cancer or ulcers. Among them, thoracic aortic aneurysm is responsible for approximately two-thirds of AEFs. Rapid diagnosis and repair to reduce morbidity and mortality are important in the management of AEFs. Previous reports

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