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• W2076156632 abstract "We read with great interest the report of an interesting case of endovascular stent-graft management of a secondary aorto-oesophageal fistula.1Civilini E. Bertoglio L. Melissano G. Chiesa R. Aortic and esophageal endografting for secondary aortoenteric fistula.Eur J Vasc Endovasc Surg. 2008; 36: 297-299Google Scholar In this case, apart from gastrointestinal haemorrhage, the patient presented with systemic signs of sepsis. Because the patient was deemed high risk for open surgical repair, and in the setting of haemodynamic instability, we corroborated his urgent management with the less invasive endovascular treatment. Consequently, as there was evidence of persistent leak from the oesophageal lumen into the peri-aortic structures, deployment of a stent-graft within the oesophagus was undertaken, along with percutaneous drainage of the peri-graft collection. Microbiology of the drained fluid revealed positive cultures. However, scepticism exists regarding the placement of a prosthetic material in an already infected field, and the possibility of persistent/recurrent infection with often devastating consequences remains a concern.2Burks Jr., J.A. Faries P.L. Gravereaux E.C. Hollier L.H. Marin M.L. Endovascular repair of bleeding aortoenteric fistulas: a 5-year experience.J Vasc Surg. 2001; 34: 1055-1059Google Scholar In a systematic review conducted at our institution, aiming to assess the factors associated with poor outcome after endovascular stent-graft treatment of aorto-enteric fistula, it was found that evidence of sepsis preoperatively was a strong factor indicating poor outcome (P<0.05), despite the interruption of the aorto-enteric communication.3Antoniou G.A. Koutsias S. Antoniou S.A. Georgiakakis A. Lazarides M.K. Giannoukas A.D. Outcome after endovascular stent graft repair of aorto-enteric fistula: a systematic review.J Vasc Surg. Nov 21, 2008; https://doi.org/10.1016/j.jvs.2008.08.068Google Scholar Therefore, we strongly advocate that endovascular repair of the aorto-oesophageal fistula should be a bridge to open surgical repair, when optimisation of the patient's condition has been achieved. Aortic and Esophageal Endografting for Secondary Aortoenteric FistulaEuropean Journal of Vascular and Endovascular SurgeryVol. 36Issue 3PreviewThe aorto-esophageal fistula is a well-recognized and potentially fatal complication of thoracic aortic surgery. Several strategies regarding its prevention and subsequent management have been described. We report the management of a large midthoracic fistula complicating redo thoraco-abdominal aortic surgery by the placement of covered stents in the aorta and esophagus to successfully exclude the lesion. While long term durability is uncertain, endografts and long-term antibiotics provide a therapeutic option for palliation in patients unfit for immediate surgery. Full-Text PDF Open ArchiveResponse to Letter to the editor re: ‘Aortic and Oesophageal Endografting for Secondary Aorto-enteric Fistula’European Journal of Vascular and Endovascular SurgeryVol. 37Issue 5PreviewWe appreciate the opportunity to reply to the letter from G.A. Antoniou and A.D. Giannoukas, which raises important issues. We agree that endovascular repair is an emergency bailout procedure to stabilise the patients, improving survival after delayed open surgery. We are pleased to update this case report 16 months after the endoluminal life-saving procedure was performed. At 5 months, the recovery of the patient was satisfactory; however, he stopped the antibiotic therapy 1 month later for reasons that are not clear and soon the fever returned. Full-Text PDF Open Archive" @default.
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• W2076156632 title "Regarding “Civilini E, Bertoglio L, Melissano G, Chiesa R. Aortic and Esophageal Endografting for Secondary Aortoenteric Fistula. Eur J Vasc Endovasc Surg 2008;36(3):297–9”" @default.
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