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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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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author Sarah Kim, BA
Patrick D. Conroy, MD
Mark Zemela, MD
Bruce L. Tjaden, Jr., MD
author_facet Sarah Kim, BA
Patrick D. Conroy, MD
Mark Zemela, MD
Bruce L. Tjaden, Jr., MD
author_sort Sarah Kim, BA
collection DOAJ
description 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.
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institution Kabale University
issn 2468-4287
language English
publishDate 2025-08-01
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series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-67cbd4b5b89f4e2c811f49f42edf43912025-08-20T03:56:42ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-08-0111410183710.1016/j.jvscit.2025.101837Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumabSarah Kim, BA0Patrick D. Conroy, MD1Mark Zemela, MD2Bruce L. Tjaden, Jr., MD3Cooper Medical School of Rowan University, Camden, NJDepartment of Vascular and Endovascular Surgery, Cooper University Hospital, Camden, NJ; Correspondence: Patrick D. Conroy, MD, Cooper University Hospital, 3 Cooper Plaza, Ste 411, Camden, NJ 08103Department of Vascular and Endovascular Surgery, Cooper University Hospital, Camden, NJDepartment of Vascular and Endovascular Surgery, Cooper University Hospital, Camden, NJPenetrating 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.http://www.sciencedirect.com/science/article/pii/S2468428725001194Aortoesophageal fistulaPembrolizumabPenetrating aortic ulcerThoracic branch endoprosthesis
spellingShingle Sarah Kim, BA
Patrick D. Conroy, MD
Mark Zemela, MD
Bruce L. Tjaden, Jr., MD
Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
Journal of Vascular Surgery Cases and Innovative Techniques
Aortoesophageal fistula
Pembrolizumab
Penetrating aortic ulcer
Thoracic branch endoprosthesis
title Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
title_full Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
title_fullStr Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
title_full_unstemmed Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
title_short Aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
title_sort aortoesophageal fistula following thoracic branch endoprosthesis for cryptogenic penetrating aortic ulcer in a patient on pembrolizumab
topic Aortoesophageal fistula
Pembrolizumab
Penetrating aortic ulcer
Thoracic branch endoprosthesis
url http://www.sciencedirect.com/science/article/pii/S2468428725001194
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