Two patients with locally advanced squamous cell carcinoma of the mid-esophagus, with esophageal stents in situ, suffered sudden onset of massive hematemesis and hemodynamic instability due to an aortoesophageal fistula. Although their esophageal neoplasms were deemed inoperable and treatment was palliative, the bleeding was successfully stopped with an endovascular aortic stent-graft. They both remained stable with no septic or hemorrhagic complications, and survived for 14 and 16 weeks after the operation. We emphasize that even if esophageal tumors are locally advanced, emergency endovascular management of aortoesophageal fistula is worthwhile for prolongation of survival.
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