Abstract Text A 48-year-old male with a persistent gastric conduit leak after Ivor-Lewis esophagectomy,
despite 3 sessions of EVT, was referred to our team. Endoscopy confirmed persistence
of a 25mm long defect, however, no contrast extravasation could be seen. Retroflexion
allowed identification of a 4mm orifice, located deeply in the defect’s proximal end,
not visible in anteflexion. Contrast instillation and guidewire passage confirmed
the presence of a gastropleural fistula. A TTS-clip was placed at defect’s distal
end and an OTS-clip was deployed at defect’s proximal end, enveloping the area of
the 4mm orifice. One additional TTS-clip was placed between OTS-clip and previous
TTS-clip to ensure complete closure of the fistula orifice [1]
[2]
[3].
