Oesophageal fistulae after
thoracic endovascular aneurysm repair (
TEVAR) for
thoracic aortic aneurysm (TAA) have been reported, although the causes are unknown. One hypothesis is that the structural configuration of the
aortic aneurysm, as it protrudes towards the oesophagus, may affect oesophageal
fistula formation. The pathological findings of an oesophageal
fistula following
TEVAR are reviewed here. This report presents the case of a 68-year-old man with a
stent graft-related oesophageal
fistula after
TEVAR for TAA. The oesophageal
fistula suddenly appeared on the 11th day after
TEVAR, and oesophagectomy was performed, without
stent graft extirpation. The pathological findings showed neutrophil infiltration from the adventitia to the mucosa and congestion in the capillaries of the oesophageal wall around the site of penetration and no
bacterial infection. There have been reports with logical hypotheses about the causes of
stent graft-related oesophageal fistulae. Our pathological findings support the theory that pressure
necrosis or ischaemic insult by physical compression of a rigid thrombosed
aneurysm may result in
fistula formation. For descending
aortic aneurysms that protrude toward the oesophagus, caution must be exercised to prevent oesophageal
fistula formation after
TEVAR.