Aorto-oesophageal and aortobronchial fistulae following thoracic endovascular aortic repair: a national survey.
Eur J Vasc Endovasc Surg
; 39(3): 273-9, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20096612
ABSTRACT
OBJECTIVE:
We evaluated the incidence of aorto-oesophageal (AEF) and aortobronchial (ABF) fistulae after thoracic endovascular aortic repair (TEVAR), and investigated their clinical features, determinants, therapeutic options and results.METHODS:
We conducted a voluntary national survey among Italian universities and hospital centres with a thoracic endovascular programme.RESULTS:
Thirty-nine centres were contacted, and 17 participated. Of the patients who underwent TEVAR between 1998 and 2008, 19/1113 (1.7%) developed AEF/ABF. Among indications to TEVAR, aortic pseudo-aneurysm was associated with the development of late AEF/ABF (P = 0.009). Further, emergent and complicated procedures resulted in increased risk of AEF/ABF (P = 0.008 and P < 0.001, respectively). Eight patients were treated conservatively, all of whom died within 30 days. Eleven patients underwent AEF/ABF surgical treatment, with a perioperative mortality of 64% (7/11). At a mean follow-up of 17.7 +/- 12.5 months, overall survival was 16% (3/19).CONCLUSIONS:
The incidence of AEF and ABF following TEVAR is not negligible, and is comparable to that following open repair. This finding warrants an ad hoc long-term follow-up after TEVAR, particularly in patients submitted to emergent and complicated procedures. Both surgical and endovascular treatment of AEF/ABF are associated with high mortality. However, conservative treatment does not appear to be a viable option.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aorta Torácica
/
Doenças da Aorta
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Fístula Vascular
/
Fístula Brônquica
/
Fístula Esofágica
/
Implante de Prótese Vascular
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Vasc Endovasc Surg
Ano de publicação:
2010
Tipo de documento:
Article