Thoracic Endovascular Aortic Repair of Esophageal Cancer-Associated Aortoesophageal Fistula: A Case Report and Literature Review

Figure 1

Imaging at the initial treatment for the aortoesophageal fistula using the TEVAR method. (a) EGD revealed a type 2 lesion spanning 3/4 of the circumference of the middle thoracic esophagus. (b) Computed tomography scan (CT) revealed esophageal wall thickening with tumor, and there was loss of the normal fat plane between the esophagus and the adjacent aorta. Approximately 90° of the circumference of the aorta was in contact with the tumor, which suggested aortic invasion (yellow thin arrow). (c) CT scan revealed aortic erosion of the intravenous contrast material within the descending thoracic aorta and extraluminal foci of air between the adjacent esophagus and the aorta (yellow thin arrow). (d) CT angiography did not indicate active bleeding. (e) Emergency esophagogastroduodenoscopy showed a pale fragile esophageal lesion on the posterior wall, an area previously treated with chemoradiation therapy, with massive blood coagulation. (f) Marking clips were placed on the side opposite the lesion.

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