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Endovascular Repair of an Aortopulmonary Fistula via the Axillary Artery

  • Published:
Annals of Vascular Surgery

Abstract

A 62-year-old man presented with several months of progressive hemoptysis. He has a history of aortobifemoral bypass and thoracofemoral bypass grafts, which were both removed due to infection. Evaluation with multiple imaging modalities revealed a descending thoracic aortic pseudoaneurysm around the retained Dacron™ graft with bronchiectatic changes and consolidation of the adjacent left lower lobe. No evidence of direct arterial communication between the aorta and the bronchioles was ever demonstrated, but an aortopulnionary fistula was suspected. Endovascular repair with several Excluder aortic cuffs stacked in the thoracic aorta was successfully performed via the axillary artery. Exclusion of the pseudoaneurysm with no evidence of endoleak was noted on computed tomography 2 months postoperatively, at which time the patient reported complete resolution of his hemoptysis. To our knowledge, this is the first report of endovascular repair of an aortopulmonary fistula via the axillary artery.

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References

  1. MacIntosh EL, Parrott JC, Unruh HW. Fistulas between the aorta and the tracheobronchial tree. Ann. Thorac. Surg. 1991;51:515–519

    Google Scholar 

  2. Favre JP, Gournier JP, Adham M, Rosset E, Barral X. Aortobronchial fistula: report of three cases and review of the literature. Surgery 1994; 115:264–270

    Google Scholar 

  3. Piciche M, Paulis RD, Fabbri A, Chiariello L. Postoperative aortic fistulas into the airways: etiology, pathogenesis, presentation, diagnosis, and management. Ann. Thorac. Surg. 2003;75:1998–2006

    Google Scholar 

  4. Kalkat MS, Bonser RS. Management of aortobronchial fistula following coarctation repair. Eur. J. Cardiothorac. Surg. 2003;23:116–118

    Google Scholar 

  5. Campagna AC, Wehner JH, Kirsch CM, et al. Endovascular stenting of an aortopulmonary fistula presenting with hemoptysis: a case report. J. Cardiovasc. Surg. 1996;37:643–646

    Google Scholar 

  6. Miyata T, Ohara N, Shigematsu H, et al. Endovascular stent graft repair of aortopulmonary fistula. J. Vasc. Surg. 1999;29:557–560.

    Google Scholar 

  7. Smayra T, Otal P, Soula P, et al Pseudoaneurysni and aortobronchial fistula after surgical bypass for aortic coartation: management with endovascular stent graft. J. Endovasc. Ther. 2001;8:422–428

    Google Scholar 

  8. Thompson CS, Ramaiah VG, Rodriguez-Lopez JA, et al Endoluminal stent graft repair of aortobronchial fistulas. J. Vasc. Surg. 2002;35:387–391

    Google Scholar 

  9. Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ. Variables predictive of outcome in 832 patients undergoing repairs of the descending thoracic aorta. Chest 1993;104:1248–1253

    Google Scholar 

  10. Bush RL, Lin PH, Lumsden AB. Endovascular treatment of the thoracic aorta. Vasc. Endovasc. Surg. 2003;37:399–405

    Google Scholar 

  11. Chuter TA, Ivancev K, Lindblad B, et al. Endovascular stent-graft exclusion of an aortobronchial fistula. J. Vasc. Interv. Radiol. 1996;7:357–359

    Google Scholar 

  12. Karmy-Jones R, Lee CA, Nicholls SC, Hoffer E. Management of aortobronchial fistula with an aortic stent graft. Chest 1999;116:255–257

    Google Scholar 

  13. Dorweiler B, Dueber C, Neufang A, et al. Endovascular treatment of acute bleeding complications in traumatic aortic rupture and aortobronchial fistula. Eur J Cardiothorac. Surg. 2001;19:739–745

    Google Scholar 

  14. Caiati JM, Marin ML, Flores RM. Endovascular management of an aortobronchial fistula arising after resection of a primary aortic sarcoma: a case report. Vasc. Surg. 2001;35:73–79

    Google Scholar 

  15. Leobon B, Roux D, Mugniot A, et al. Endovascular treatment of thoracic aortic fistulas. Ann. Thorac. Surg. 2002;74:247–249

    Google Scholar 

  16. Orend KH, Scharrer-Pamler R, Kapfer X, et al. Endovascular treatment in diseases of the descending aorta: 6 year results of a single center. J. Vasc. Surg. 2003;37:91–99

    Google Scholar 

  17. Numan F, Arbatli H, Yagan N, Demirsoy E, Sonmez B. Endovascular treatment of an aortobronchial fistula. Cardiovasc. Intervent. Radiol. 2003;27:71–73

    Google Scholar 

  18. Boclder D, Schumacher H, Schwarzbach M, et al. Endoluminal stent-graft repair of aortobronchial fistulas: bridging or definitive long term solution? J. Endovasc. Ther. 2004;11:41–48

    Google Scholar 

  19. Estes JM, Halin N, Kwoun M, et al. The carotid artery as alternative access for endoluminal aortic aneurysm repair. J. Vasc. Surg. 2001;33:650–653

    Google Scholar 

  20. Heidenreich MJ, Neschis DG, Costanza MJ, Flinn WR. Endovascular repair of a penetrating thoracic aortic ulcer by way of the carotid artery. J. Vasc. Surg. 2003;38:1407–1410

    Google Scholar 

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Correspondence to Erik L. Owens MD.

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Kaw, L.L., Owens, E.L. & Kansal, N. Endovascular Repair of an Aortopulmonary Fistula via the Axillary Artery. Ann Vasc Surg 19, 487–491 (2005). https://doi.org/10.1007/s10016-005-4641-6

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  • DOI: https://doi.org/10.1007/s10016-005-4641-6

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