Tratamiento endovascular urgente de una fístula aortobronquial primaria. Presentación de un caso y revisión de la bibliografía

Introduction. An aortobronchial fistula is a pathological communication between the thoracic aorta and the bronchial tree, usually the left hemithorax. It is a rare condition today, although its natural history has fatal consequences if left untreated. Most cases present as complications arising from classical surgery on the thoracic aorta or secondary to post-traumatic aortic pseudoaneurysms and mycotic aneurysms. Case report. The most striking feature of this case is the presence of a fistulised saccular aneurysm in the left bronchial tree in a female patient who had no risk factors for arteriosclerosis or any history of traumatic injuries, surgical interventions or infections. It was successfully sealed by urgent placement of a thoracic aortic stent. Our case report is accompanied by a review of the literature that systematises the presenting symptoms, the diagnosis and suitable treatment. Conclusions. Owing to its latent fatal potential, we consider this clinical condition to be amenable to urgent treatment by placement of an aortic stent as the preferred treatment rather than conventional surgical treatment. [ANGIOLOGIA 2008; 60: 419-24]