Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab

Penetrating aortic ulcers are uncommon and life-threatening. We describe the case of a 67-year-old man who presented with fever and chills and was found on computed tomographic scan to have a thoracic penetrating aortic ulcer. The patient underwent placement of a thoracic branch endoprosthesis, with...

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Bibliographic Details
Main Authors: Sarah Kim, BA, Patrick D. Conroy, MD, Mark Zemela, MD, Bruce L. Tjaden, Jr., MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468428725001194
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Summary:Penetrating aortic ulcers are uncommon and life-threatening. We describe the case of a 67-year-old man who presented with fever and chills and was found on computed tomographic scan to have a thoracic penetrating aortic ulcer. The patient underwent placement of a thoracic branch endoprosthesis, with a postoperative course complicated by ileocolic pseudoaneurysm, progressive aortitis, and a fatal aortoesophageal fistula. The management of penetrating aortic ulcer in the setting of multiple confounding factors is discussed in the context of this patient’s complex medical presentation, with a focus on the potential role of pembrolizumab in his disease progression.
ISSN:2468-4287