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Successful management of aortoesophageal fistula caused by esophageal cancer using thoracic endovascular aortic repair

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Aortoesophageal fistula (AEF) is a highly life-threatening condition, even when treated promptly. However, little is known about the treatment for AEF in patients with advanced esophageal cancer. We report the case of a 69-year-old man diagnosed with esophageal squamous cell carcinoma (ESCC) that was admitted to our hospital for ESCC treatment. On diagnosis of unresectable ESCC invading the thoracic aorta, chemotherapy was administered. The response to treatment after two courses was evaluated as stable disease. We performed radiation therapy followed by bypass operation for esophageal stenosis. After radiation therapy, AEF was detected. His condition improved after hemostasis using thoracic endovascular aortic repair (TEVAR). He was discharged from our care after treatment with antibiotics; he died due to cancer progression 7 months after TEVAR. AEF with ESCC is a lethal condition that may occur during cancer treatment; however, TEVAR might help improve the patient’s condition.

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Aortoesophageal fistula


Thoracic endovascular aortic repair


Esophageal squamous cell carcinoma


Computed tomography


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Authors and Affiliations



JI and TN contributed to the writing of the manuscript. JI, KY, HK, KK, and NH served as the attending physicians of the presented patient. KH supervised the study. All authors read and approved the final manuscript.

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Correspondence to Tsutomu Namikawa.

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Jun Iwabu, Tsutomu Namikawa, Keiichiro Yokota, Hiroyuki Kitagawa, Kazuki Kihara, Nobuyuki Hirose, and Kazuhiro Hanazaki declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Iwabu, J., Namikawa, T., Yokota, K. et al. Successful management of aortoesophageal fistula caused by esophageal cancer using thoracic endovascular aortic repair. Clin J Gastroenterol 13, 678–682 (2020).

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