Direct visualization of postoperative aortobronchial fistula on computed tomography

Table 1 Patient characteristics

Characteristics		n	Precent
Age	Mean age (years)	71
Gender	Male	4/6	66.7
	Female	2/6	33.3
Surgery	Aortic replacement	2/6	33.3
	Aortic replacement + TEVAR	3/6	50
	TEVAR	1/6	16.7
	Mean period surgery to ABF detection	14 years
Complication	Hemoptysis	3/6	50
	Graft infection	4/6	66.6
	Mean period surgery to complication	15.5 years
	Mean period ABF to complication	4 years
Treatment	Conservative treatment	4/6	66.7
	Abscess drainage	1/6	16.7
	Aortic replacement	1/6	16.7
Outcome	Deaths	2/6	33.3
	Alive	3/6	50
	Lost to follow-up	1/6	16.7
	Mean observation period	7 years

ABF: Aortobronchial fistula; TEVAR: Thoracic endovascular aortic repair.

Table 2 Clinical presentation

Case	Primary disease	Surgery	Period: Surgery to ABF	Complication	Period ABF to complication	Treatment	Outcome	Observation period
F: 73 years	Dissection Marfan syndrome	Replacement + TEVAR	5 years	No	No	No	Alive	5 months
F: 74 years	Aneurysm	Replacement TEVAR (10 years after replacement)	10 years (1 year)	Graft infection hemoptysis	2 years	Drainage	Died hemoptysis	6 years
M: 67 years	Aortic coarctation Aneurysm	Replacement	26 years	Graft infection hemoptysis	Simultaneous	Conservative	Alive	2 years
M: 73 years	Infected aneurysm	TEVAR	1 year	Graft infection	Simultaneous	Conservative	Died sepsis	1 year
M: 57 years	Aneurysm	Replacement TEVAR (14 years later from replacement)	16 years (3 years)	Graft infection hemoptysis	7 years	Replacement TEVAR	Alive	18 years
M: 83 years	Aneurysm	Replacement	23 years	No	No	No	Lost to follow-up	7 years

F: Famale; M: Male; ABF: Aortobronchial fistula; TEVAR: Thoracic endovascular aortic repair.

Table 3 Summary of symptoms and image findings

		Initial CT (n = 6)		Onset CT (n = 4)		Follow-up CT (n = 6)
		n	%	n	%	n	%
Symptoms	Asymptomatic	4/6	66.7	-		3/6	50
	Fever	1/6	16.7	3/4	75	3/6	50
	Hemoptysis	1/6	16.7	1/4	25	1/6	16.7
Locations of ABF	Ascending aorta	1/6	16.7	0/4	0	1/6	16.7
	Aortic arch	2/6	33.3	1/4	25	1/6	16.7
	Aortic arch descending aorta	1/6	16.7	2/4	50	2/6	33.3
	Descending aorta	2/6	33.3	1/4	25	2/6	33.3
Image findings	Direct confirmation of ABF	3/6	50	1/4	25	3/6	50
	Fluid collection	4/6	66.7	4/4	100	4/6	66.7
	Ring enhancement	1/2	50	3/3	100	1/2	50
	Endoleak/Pseudoaneurysm	1/2	50	3/3	100	1/2	50
	Bronchodilation	6/6	100	4/4	100	6/6	100
	Atelectasis	5/6	83.3	4/4	100	5/6	83.3
	Dirty fat sign	2/6	33.3	4/4	100	3/6	50
	Pulmonary hemorrhage	0/6	0	0/4	0	0/6	0

CT: Computed tomography; ABF: Aortobronchial fistula.

Table 4 Symptoms and image findings

Case	CT	Fever	Hemoptysis	Peri-graft air location	Around graft with air (peri-graft air)
					Fluid	Ring enhancement	Endoleak/Pseudo-aneurysm	Direct confirmation of ABF	Bronchodilation	Atelectasis	Dirty fat sign	Pulmonary hemorrhage
1	Initial	No	No	As	No	-	-	Rt B3	Rt B3	No	No	No
	Latest	No	No	As	No	-	-	Rt B3	Rt B3	No	No	No
2	Initial	No	No	Arc	(+)	-	-	Lt B1 + 2	Lt B1 + 2	(+)	No	No
	Onset	(+)	No	Arc-Des	(+)	(+)	Type 2 endoleak	Lt B1 + 2, B6	Lt B1 + 2, B6	(+)	(+)	No
	Latest	(+)	(+)	Arc-Des	(+)	(+)	Type 2 endoleak	No	(+)	(+)	(+)	No
3	Initial/Onset	No	(+)	Arc-Des	(+)	(+)	Pseudoaneurysm	No	(+)	(+)	(+)	No
	Latest	(+)	No	Arc-Des	(+)	-	-	No	(+)	(+)	(+)	No
4	Initial/Onset	(+)	No	Arc	(+)	-	-	No	(+)	(+)	(+)	No
	Latest	(+)	No	Arc	(+)	-	-	Lt B1 + 2	Lt B1 + 2	(+)	(+)	No
5	Initial	No	No	Des	No	No	No	Lt B6	Lt B6	(+)	No	No
	Onset	(+)	(+)	Des	(+)	(+)	Type 2 endoleak	No	Lt B6	(+)	(+)	No
	Latest	No	No	Des	No	-	-	Lt B6	Lt B6	(+)	No	No
6	Initial	No	No	Des	(+)	-	-	No	(+)	(+)	No	No
	Latest	No	No	Des	(+)	No	No	No	(+)	(+)	No	No

CT: Computed tomography; ABF: Aortobronchial fistula; As: Ascending aorta; Arc: Arch; Des: Descending aorta; Rt: Right; Lt: Left.