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  • Title: Pseudoaneurysm and aortobronchial fistula after surgical bypass for aortic coarctation: management with endovascular stent-graft.
    Author: Smayra T, Otal P, Soula P, Chabbert V, Cérène A, Joffre F, Rousseau H.
    Journal: J Endovasc Ther; 2001 Aug; 8(4):422-8. PubMed ID: 11552735.
    Abstract:
    PURPOSE: To report the endovascular repair of an aortobronchial fistula at the distal anastomosis of a complex thoracic graft. CASE REPORT: A 61-year-old man operated 18 years prior for aortic coarctation presented with hemoptysis. An aortobronchial fistula was suspected, but spiral computed tomography and angiography showed only a small pseudoaneurysm at the distal anastomosis without revealing the fistulous tract. A Talent stent-graft was successfully deployed through a femoral access, but the large delivery system injured the external iliac artery, producing a retroperitoneal hemorrhage. Prompt balloon occlusion of the aorta and subsequent bypass graft repair of the arterial injury prevented serious sequelae. The patient recovered without further complications. Follow-up imaging to 2 years has documented exclusion of the pseudoaneurysm with no hemoptysis or signs of new false aneurysm formation. CONCLUSIONS: Endovascular exclusion of anastomotic pseudoaneurysms even in complicated cases can be an efficient treatment option, but the procedure must be carefully planned and executed in order to achieve good results.
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