AB 67. Successful endovascular management of massive
hemoptysis secondary to aortobronchial fistula, ten
years after thoracic aorta traumatic rupture
Background: Hemoptysis, secondary to aortobronchial fistula, is a rare
and potentially fatal condition. We present a case report of noninvasive
endovascular treatment of hemoptysis due to aortobronchial fistula, in a
patient with a history of thoracic aorta traumatic rupture.
Patients and methods: A 55-year-old man presented with massive
hemoptysis and a 2-month history of recurrent hemoptysis. Ten years
previously, the patient had undergone thoracic aortic interposition of
Dacron graft as a surgical repair of thoracic aorta traumatic rupture.
Despite the severity of bleeding, the patient was haemodynamically stable. Spiral computed tomography angiography of the thorax revealed
a saccular pseudoaneurysm of thoracic aorta of about 4.2 cm in diameter
at the level of the previous aortic repair. The computed tomography
examination also revealed alveolar infiltrations and a ground-glass
appearance in the adjacent left upper lobe, indicative of extravasation to the
Results: Under the impression of aortobronchial fistula, a digital
angiography was immediately performed. It confirmed the diagnosis
and an endovascular tubular graft Gore TAG was interposed via femoral
approach. The bleeding ceased gradually and the patient was discharged free
of symptoms. At the 1-month and 2-month follow up, the CT revealed an
improvement of the infiltrations and a decrease of the pseudoaneurysm size.
Conclusions: Aortobronchial fistula should be included in the
differential diagnosis in patients with hemoptysis and even a long
history of thoracic aorta traumatic rupture. Endovascular stenting seems
to represent a safe, non invasive therapeutical option. Early diagnosis,
prompt management and long term follow up maybe proved lifesaving.
Cite this abstract as: Serasli E, Michailidis V, Aggelos M, Siopi D, Chloros D,
Pelekas D, Christoforatou K, Tsara V. Successful endovascular management
of massive hemoptysis secondary to aortobronchial fistula, ten years after
thoracic aorta traumatic rupture. J Thorac Dis 2012;4(S1):AB67. DOI: 10.3978/