gms | German Medical Science

122. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

05. bis 08.04.2005, München

Aortic stent-grafts in aortobronchial fistulas (ABFs)

Meeting Abstract

  • corresponding author M. Gawenda - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln
  • J. Aleksic - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln
  • M. Zähringer - Institut für Radiologische Diagnostik, Klinikum der Universität zu Köln
  • J. Brunkwall - Schwerpunkt Gefäßchirurgie, Klinikum der Universität zu Köln

Deutsche Gesellschaft für Chirurgie. 122. Kongress der Deutschen Gesellschaft für Chirurgie. München, 05.-08.04.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05dgch2690

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgch2005/05dgch451.shtml

Veröffentlicht: 15. Juni 2005

© 2005 Gawenda et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction

ABFs are rare but fatal complications following thoracic aortic operations. Open repair carries the risk of high mortality rate. Currently, endoluminal stentgrafting is offered as the preferred method of treatment. According to experimental data, suggesting that stentgrafts are more susceptible to prosthetic infection, this recommendation is dubious.

Materials

In a cohort of 39 patients, treated at our institution between 1999 and 2004 for thoracic aortic pathology with endoluminal stent grafts, 3 patients (2 men; mean age 50 years, range 42-62) presented hemoptysis. The diagnostics confirmed the occurrence of post-surgical ABFs.Additionally, we performed a systematic bibliographic review dealing with the key words "aortobronchial fistula" and "endovascular".

Results

Procedural success was achieved in all patients with ABFs without peri-procedural complications. Clinical success was achieved in 2 patients (follow-up: 27.5 and 50 months). A third patient presented a type-II-endoleak with stable aneurysm diameter. During follow-up (15.5 months) he developed multiple mycotic aneurysms at the visceral and deep femoral arteries (induced by Candida species) requiring surgical intervention.The current literature to August 2004, reviewed 34 cases of ABFs treated endoluminally. Regardless of the high rate of technical success (>90%), the rate of therapy failure (mortality and recurrence of ABFs) during follow-up was quite high (30%).

Discussion

The presented cases and the systemic bibliographic review demonstrated that endoluminal stent grafting is a therapeutic option at ABFs, mainly to control life-threatening hemoptysis. But the susceptibility to prosthetic infection with recurrent ABFs and hemorrhagic episodes indicate that endoluminal stent grafting is not a long-term solution.