PMC4681956_01
Preoperative computed tomography (CT) images of the chest consistent with aortobronchial fistula (ABF). (A) Unenhanced CT showing mass initially thought to be a neoplasm (white arrow). (B) Enhanced CT showing ABF (yellow arrow).
gr1.jpg
PMC4681956_01_gr1.jpg
fig1
Prior to a bronchoscopy, a vascular surgery consultation recommended an enhanced CT, which revealed a pseudoaneurysm of the aorta surrounded by lung tissue consistent with findings of an aortobronchial fistula (ABF) (Fig. 1).
Intra-operative angiogram during thoracic endovascular aneurysm repair (TEVAR) illustrating successful exclusion of the aortobronchial fistula.
gr2.jpg
PMC4681956_01_gr2.jpg
fig2
The graft was positioned under direct fluoroscopy such that it covered the aorta above the pseudoaneurysm by 4 cm, and distally by 2 cm (Fig. 2). There were no intra-operative issues and the patient recovered well.
CT image of the chest showing thoracic endovascular aneurysm repair successfully excluding the aortobronchial fistula. (White arrow - endovascular stent graft).
gr3.jpg
PMC4681956_01_gr3.jpg
fig3
The patient will need lifelong surveillance to prevent recurrence, including regular CT scan follow-up to ensure no endoleak or migration of the endovascular prosthesis (Fig. 3).