Aortoesophageal fistula treated with emergent thoracic stent grafting

Aortoesophageal fistula (AEF) is a rare pathology with a poor prognosis. Historically, open repair approaches were undertaken. With the advent of endovascular techniques, alternative methods such as thoracic endovascular aortic repair (TEVAR) have emerged. This case describes a patient who presented with severe hematemesis and, upon imaging, an AEF was discovered. Urgent TEVAR was indicated with a graft oversized to the native aorta by 10% to 15%, along with coil embolization of the intercostal artery. We report here on the successful management of AEF via TEVAR.