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Updated: Jun 27, 2026
06:12
Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Aortoesophageal Fistula: Mending the Lethal Connection-A Systematic Review and Meta-Analysis
Noor Abu Hantash1, Hazem El Beyrouti2, Yousef Alghzawi3
1School of Medicine, University of Jordan, Amman, Jordan; Cardiothoracic Surgery Interest Group, University of Jordan, Amman, Jordan.
Annals of Vascular Surgery
|June 25, 2026
Summary
Aortoesophageal fistula (AEF) management remains challenging with high mortality. While staged TEVAR followed by surgery improves survival, it increases complications, necessitating individualized, morphology-guided treatment.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Interventional Cardiology
Background:
- Aortoesophageal fistula (AEF) is a rare and life-threatening condition.
- Limited high-quality evidence exists to guide AEF management.
Purpose of the Study:
- To systematically review and analyze survival and complication outcomes for AEF based on treatment strategies and disease severity.
- To compare the efficacy of different management approaches for AEF.
Main Methods:
- Systematic review and meta-analysis of PubMed and Scopus databases up to December 2025.
- Categorization of patients into five treatment groups: TEVAR alone, staged TEVAR with surgery, primary open/hybrid surgery, TEVAR with esophageal stenting, and supportive care.
- Pooled analysis of outcomes, including mortality, infection, reintervention, and recurrence rates.
Main Results:
- Overall 30-day mortality was 31.2% and one-year mortality was 41.2%.
- Staged TEVAR followed by surgery showed improved survival but high infection (66.7%) and reintervention (43.2%) rates.
- TEVAR alone had the lowest one-year mortality (25.5%) among definitive strategies but a high recurrence rate (26.9%). TEVAR with esophageal stenting had low early mortality (5.0%) but high reintervention (54.5%).
- Morphological severity strongly correlated with adverse outcomes, with Type IV lesions having a poor prognosis.
Conclusions:
- AEF continues to have high mortality despite current treatments.
- Definitive management strategies, particularly staged TEVAR and surgery, improve survival but are associated with significant complications.
- Individualized treatment plans guided by AEF morphology are recommended.
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