PMID- 33981754
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220423
IS  - 2297-4725 (Print)
IS  - 2297-475X (Electronic)
IS  - 2297-4725 (Linking)
VI  - 37
IP  - 2
DP  - 2021 Mar
TI  - A Single-Center Case Series of Endoscopically Treated Aorto-Gastrointestinal 
      Fistula after Endovascular Aortic Repair: Surgery Is Still the Only Valid 
      Solution.
PG  - 134-141
LID - 10.1159/000507821 [doi]
AB  - INTRODUCTION: Aortoesophageal fistula (AEF) is a life-threatening complication 
      associated with endovascular aortic repair (EVAR) and occurs mostly in patients 
      who undergo thoracic EVAR (TEVAR). To date, surgical treatment of AEF has been 
      considered the most promising therapeutic approach. New endoscopic techniques 
      could contribute to the therapy of AEF. The aim of this study was to analyze the 
      outcome after endoscopic treatment of EVAR-associated AEF. METHODS: All patients 
      who received endoscopic diagnostics and/or therapy for AEF after EVAR/TEVAR in 
      our center between 2010 and 2019 were evaluated. RESULTS: Seven suitable patients 
      were included. Six of them had undergone TEVAR and 1 had EVAR. Fistula occurred 
      at an average of 307 days (range 21-2,774 days) post-EVAR. Endoscopic treatment 
      was performed on 4 patients by using an over-the-scope clip (OTSC(R)). However, 
      fistula recurred in all patients who were initially treated endoscopically. They 
      were then treated either by sequential application of further OTSCs(R) or by 
      implantation of a fully coated, self-expanding metal stent. One of these patients 
      underwent a partial esophageal resection in a subsequent treatment approach. All 
      patients died during the observational period, 5 as a direct consequence of the 
      AEF/aortoduodenal fistula and 2 due to comorbidities. The median survival time 
      after fistula occurrence was 120 days (range 5-823 days). CONCLUSION: Endoscopic 
      treatment of AEF with OTSC(R) should be considered as a possible interim solution, 
      especially in patients with severe comorbidities. However, surgical remediation 
      still appears to be the only procedure with intermediate to long-term therapeutic 
      success.
CI  - Copyright (c) 2020 by S. Karger AG, Basel.
FAU - Kubesch, Alica
AU  - Kubesch A
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
FAU - Waidmann, Oliver
AU  - Waidmann O
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
FAU - Blumenstein, Irina
AU  - Blumenstein I
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
FAU - Bechstein, Wolf Otto
AU  - Bechstein WO
AD  - Department of General and Visceral Surgery, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
FAU - Friedrich-Rust, Mireen
AU  - Friedrich-Rust M
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
FAU - Jung, Michael
AU  - Jung M
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
FAU - Albert, Jorg
AU  - Albert J
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
AD  - Department of Internal Medicine, Robert-Bosch-Hospital, Stuttgart, Germany.
FAU - Hausmann, Johannes
AU  - Hausmann J
AD  - Department of Internal Medicine 1, Goethe-University Hospital Frankfurt, 
      Frankfurt, Germany.
AD  - Department of Gastroenterology, St. Vinzenz-Hospital Hanau, Hanau, Germany.
LA  - eng
PT  - Journal Article
DEP - 20200701
PL  - Switzerland
TA  - Visc Med
JT  - Visceral medicine
JID - 101681546
PMC - PMC8077538
OTO - NOTNLM
OT  - Aortoesophageal fistula (AEF)
OT  - Endoscopy
OT  - Endovascular aortic repair (EVAR)
OT  - Fistula
OT  - OTSC(R)
OT  - Stent
OT  - TEVAR
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2021/05/14 06:00
MHDA- 2021/05/14 06:01
PMCR- 2022/03/01
CRDT- 2021/05/13 06:30
PHST- 2020/02/12 00:00 [received]
PHST- 2020/04/09 00:00 [accepted]
PHST- 2021/05/13 06:30 [entrez]
PHST- 2021/05/14 06:00 [pubmed]
PHST- 2021/05/14 06:01 [medline]
PHST- 2022/03/01 00:00 [pmc-release]
AID - vis-0037-0134 [pii]
AID - 10.1159/000507821 [doi]
PST - ppublish
SO  - Visc Med. 2021 Mar;37(2):134-141. doi: 10.1159/000507821. Epub 2020 Jul 1.