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Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer

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Abstract

Background

Bleeding from the thoracic aorta is potentially fatal in patients with advanced esophageal cancer. Thoracic endovascular aortic repair (TEVAR) was recently applied for aortic invasion by esophageal cancer. However, only a few case reports have been published. This study was performed to clarify the effectiveness and safety of TEVAR for patients with advanced esophageal cancer.

Methods

We retrospectively reviewed 18 patients who underwent TEVAR for esophageal cancer. We also performed a literature search and reviewed 21 similar cases.

Results

From 2007 to 2016, 10 patients were treated on an emergent basis for aortic hemorrhage (salvage group) and 8 patients underwent urgent prophylactic surgery (prophylactic group). Hemostasis was achieved in all cases. One (10%) patient in the salvage group died of aspiration pneumonia on postoperative day 1, while all patients in the prophylactic group survived for >1 month. The median survival period in the salvage and prophylactic group was 3.25 and 11.10 months, respectively. The longest survivor was still alive 9 years after TEVAR and chemoradiotherapy. No fatal adverse events or negative impacts on subsequent treatment for esophageal cancer occurred.

Conclusions

TEVAR is feasible, safe, and effective in preventing fatal aortic hemorrhage secondary to esophageal cancer invasion, although it is palliative in most cases. Because the outcomes of emergent TEVAR after bleeding tended to be worse in the salvage than in prophylactic group, prophylactic TEVAR may be considered a viable treatment option for patients with aortic invasion by advanced esophageal cancer.

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References

  1. Nemoto K, Takai Y, Ogawa Y et al (1998) Fatal hemorrhage in irradiated esophageal cancer patients. Acta Oncol 37:259–262

    Article  CAS  PubMed  Google Scholar 

  2. Tachimori Y, Kanamori N, Uemura N et al (2009) Salvage esophagectomy after high-dose chemoradiotherapy for esophageal squamous cell carcinoma. J Thorac Cardiovasc Surg 137:49–51

    Article  PubMed  Google Scholar 

  3. Gowda RM, Misra D, Tranbaugh RF et al (2003) Endovascular stent grafting of descending thoracic aortic aneurysms. Chest 124:714–719

    Article  PubMed  Google Scholar 

  4. Ohki T, Veith FJ (2000) Endovascular grafts and other image-guided catheter-based adjuncts to improve the treatment of ruptured aortoiliac aneurysms. Ann Surg 232:466–479

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Yamatsuji T, Naomoto Y, Shirakawa Y et al (2006) Intra-aortic stent graft in oesophageal carcinoma invading the aorta. Prophylaxis for fatal haemorrhage. Int J Clin Pract 60:1600–1603

    Article  CAS  PubMed  Google Scholar 

  6. Matono S, Fujita H, Tanaka T et al (2011) Thoracic endovascular aortic repair for aortic complications after esophagectomy for cancer: report of three cases. Dis Esophagus Off J Int Soc Dis Esophagus/ISDE 24:E36–E40

    Article  CAS  Google Scholar 

  7. Kato N, Tadanori H, Tanaka K et al (2000) Aortoesophageal fistula-relief of massive hematemesis with an endovascular stent-graft. Eur J Radiol 34:63–66

    Article  CAS  PubMed  Google Scholar 

  8. Okita R, Mukaida H, Takiyama W et al (2005) Successful surgical treatment of aortoesophageal fistula after esophagectomy. Ann Thorac Surg 79:1059–1061

    Article  PubMed  Google Scholar 

  9. Cheema ZF, Davies MG, Walton BL et al (2011) Hybrid imaging to facilitate accurate placement of a thoracic endovascular aneurysm repair before completion esophagectomy. J Vasc Surg 54:1501

    Article  PubMed  Google Scholar 

  10. Ishikawa N, Maruta K, Oi M et al (2013) Thoracic endovascular repair for aorto-esophageal fistula in patients with esophageal carcinoma: report of 3 cases. Vasc Endovasc Surg 47:65–69

    Article  Google Scholar 

  11. Dorweiler B, Weigang E, Duenschede F et al (2013) Strategies for endovascular aortic repair in aortobronchial and aortoesophageal fistulas. Thorac Cardiovasc Surg 61:575–580

    Article  PubMed  Google Scholar 

  12. Okita Y, Yamanaka K, Okada K et al (2014) Strategies for the treatment of aorto-oesophageal fistula. Eur J Cardio Thorac Surg Off J Eur Assoc Cardio Thorac Surg 46:894–900

    Article  Google Scholar 

  13. Hollander JE, Quick G (1991) Aortoesophageal fistula: a comprehensive review of the literature. Am J Med 91:279–287

    Article  CAS  PubMed  Google Scholar 

  14. Dake MD, Miller DC, Semba CP et al (1994) Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med 331:1729–1734

    Article  CAS  PubMed  Google Scholar 

  15. Slonim SM, Nyman UR, Semba CP et al (1996) True lumen obliteration in complicated aortic dissection: endovascular treatment. Radiology 201:161–166

    Article  CAS  PubMed  Google Scholar 

  16. Makaroun MS, Dillavou ED, Wheatley GH et al (2008) Five-year results of endovascular treatment with the Gore TAG device compared with open repair of thoracic aortic aneurysms. J Vasc Surg 47:912–918

    Article  PubMed  Google Scholar 

  17. Matsumura JS, Melissano G, Cambria RP et al (2014) Five-year results of thoracic endovascular aortic repair with the Zenith TX2. J Vasc Surg 60:1–10

    Article  PubMed  Google Scholar 

  18. Hughes K, Guerrier J, Obirieze A et al (2014) Open versus endovascular repair of thoracic aortic aneurysms: a nationwide inpatient sample study. Vasc Endovasc Surg 48:383–387

    Article  Google Scholar 

  19. Kotelis D, Bischoff MS, Rengier F et al (2016) Endovascular repair of pseudoaneurysms after open surgery for aortic coarctation. Interact Cardiovasc Thorac Surg 22:26–31

    Article  PubMed  Google Scholar 

  20. Faure EM, Canaud L, Agostini C et al (2014) Reintervention after thoracic endovascular aortic repair of complicated aortic dissection. J Vasc Surg 59:327–333

    Article  PubMed  Google Scholar 

  21. Velazquez OC, Carpenter JP, Baum RA et al (1999) Perigraft air, fever, and leukocytosis after endovascular repair of abdominal aortic aneurysms. Am J Surg 178:185–189

    Article  CAS  PubMed  Google Scholar 

  22. Schoder M, Cartes-Zumelzu F, Grabenwoger M et al (2003) Elective endovascular stent-graft repair of atherosclerotic thoracic aortic aneurysms: clinical results and midterm follow-up AJR. Am J Roentgenol 180:709–715

    Article  Google Scholar 

  23. Kanaoka Y, Ohki T, Maeda K et al (2016) Multivariate analysis of risk factors of cerebral infarction in 439 patients undergoing thoracic endovascular aneurysm repair. Medicine 95:e3335

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bross PP, t Mannetje YW, Stokmans RA et al (2016) A 15-year single-center experience of endovascular repair for elective and ruptured abdominal aortic aneurysms. J Endovasc Ther Off J Int Soc Endovasc Spec 23:566–573

    Google Scholar 

  25. Biancari F, Mariscalco G, Mariani S et al (2016) Endovascular treatment of degenerative aneurysms involving only the descending thoracic aorta: systematic review and meta-analysis. J Endovasc Ther Off J Int Soc Endovasc Spec 23:387–392

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan

    Akira Matsumoto, Yuji Kanaoka, Takeshi Baba, Reo Takizawa, Masayuki Hara, Koji Maeda, Katsunori Nishikawa, Katsuhiko Yanaga & Takao Ohki

  2. Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara City, Tochigi, Japan

    Yutaka Suzuki

Authors
  1. Akira Matsumoto
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  2. Yuji Kanaoka
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  3. Takeshi Baba
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  4. Reo Takizawa
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  5. Masayuki Hara
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  6. Koji Maeda
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  7. Katsunori Nishikawa
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  8. Yutaka Suzuki
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  9. Katsuhiko Yanaga
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  10. Takao Ohki
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Corresponding author

Correspondence to Takao Ohki.

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Conflict of interest

Dr. Takao Ohki is a paid consultant for W.L. Gore. The remaining authors declare that they have no competing interests.

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Matsumoto, A., Kanaoka, Y., Baba, T. et al. Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer. World J Surg 42, 1551–1558 (2018). https://doi.org/10.1007/s00268-017-4334-7

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  • DOI: https://doi.org/10.1007/s00268-017-4334-7

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