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Recurrent Aortobronchial Fistula after Endovascular Stenting for Infected Pseudoaneurysm of the Proximal Descending Thoracic Aorta: Case Report

Lee Sun-Geun, 이승형, Park Won-Kyoun, 김대현, 송재원, 조상호,
소속 상세정보
 ( Lee Sun-Geun ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Thoracic and Cardiovascular Surgery
이승형 ( Lee Seung-Hyong ) - Kyung Hee University School of Medicine Kyung Hee University Hospital Department of Thoracic and Cardiovascular Surgery
 ( Park Won-Kyoun ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Thoracic and Cardiovascular Surgery
김대현 ( Kim Dae-Hyun ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Thoracic and Cardiovascular Surgery
송재원 ( Song Jae-Won ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Thoracic and Cardiovascular Surgery
조상호 ( Cho Sang-Ho ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Thoracic and Cardiovascular Surgery

Abstract


Aortobronchial fistula (ABF) induced by an infected pseudoaneurysm of the thoracic aorta is a life-threatening condition. As surgical treatment is associated with significant mortality and morbidity, thoracic endovascular aneurysm repair (TEVAR) may be an alternative for the treatment of ABF. However, the long-term durability of this intervention is largely unknown and the recurrence of ABF is a potential complication. We experienced a case of recurrent ABF after stent grafting as an early procedure for an infected pseudoaneurysm of the thoracic aorta. Remnant ABF, bronchial and/or aortic wall erosion, vasa vasorum connected with ABF, and recurrent local inflammation of the thin aortic wall around ABF might cause recurrent hemoptysis. As a result, we suggest that TEVAR should be considered as a bridge therapy for the initial treatment of ABF resulting from an infected pseudoaneurysm, and that several options, such as second-stage surgery, should be considered to prevent the recurrence of ABF.

키워드

Aorta; Aneurysm; Infected; Bronchial fistula; Endovascular procedures; Case report

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