[Thoracic Aortic Stent-graft Treatment for Pseudoaneurysm in Advanced Esophageal Cancer:Report of Two Cases].

Abstract

Aortic pseudoaneurysm is a rare complication of advanced esophageal cancer. While emergency open aortic surgery is associated with high operative mortality, massive bleeding without treatment is fatal. On the other hand, thoracic endovascular aortic repair (TEVAR) for pseudoaneurysm is far less invasive. We experienced two cases of aortic pseudoaneurysm successfully treated by TEVAR. Case 1:68-year-old male. During preoperative adjuvant chemotherapy for advanced esophageal cancer, he was diagnosed with esophageal non-aortic fistula by computed tomography (CT). Case 2:80-year-old woman. She complained dysphagia, and CT revealed an aortic pseudoaneurysm associated with mediastinal perforation of advanced esophageal cancer and direct invasion to the descending aorta. Considering their general condition, they underwent minimally invasive TEVAR. Clinical condition dramatically improved and they become able to eat well, and they were transferred to the hospice until they died of cachexia due to progression of esophageal cancer.