en Gastroentrology Gastroentrology case report case report <p><span style="font-family: times new roman;"><span style="color: rgb(0, 0, 255);"><strong><em>Background: </em></strong></span>There have been reports on stent-related vascular erosions about patients with benign or malignant stenosis of the esophagus who received endoscopic stent insertion for palliative intention for oral intake.</span></p> <p><span style="font-family: times new roman;"><span style="color: rgb(0, 0, 255);"><strong>Case presentation:</strong></span> A 61-year-old woman with esophageal cancer located in the middle part of esophagus was treated with esophagectomy. Two years following the surgery, malignant stenosis recurred in the esophagogastric anastomosis. A non-covered self-expanding metal stent (10 cm length with a diameter of 18 mm at expanded state) was inserted. Three months later, a massive hematemesis with subsequent hemorrhagic shock developed from the proximal end of the stent which resulted in the final diagnosis of arterioesophageal fistula on the left subclavian artery. An endovascular repair using a stent graft for the left subclavian artery via the right common iliac artery was performed and the patient remained well until discharge.</span></p> <p><span style="font-family: times new roman;"><span style="color: rgb(0, 0, 255);"><strong><em>Conclusion: </em></strong></span>Increase in the treatment of esophageal strictures by stent insertion increases the risk of stent-related vascular fistula. These complications should be considered in any patients with massive upper gastrointestinal bleeding.</span></p> Subclavian artery-esophageal fistula, Metal stent, Esophagogastric anastomosis, Massive hematemesis 297 299 http://caspjim.com/browse.php?a_code=A-10-38-5&slc_lang=en&sid=1 Mohammadreza Seyyedmajidi mrsmajidi55@yahoo.com 10031947532846006739 10031947532846006739 No Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran Maryam Tavassoli tavassoli1220@gmail.com 10031947532846006740 10031947532846006740 No Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran Mojtaba Kiani mojtabakiani55@yahoo.com 10031947532846006741 10031947532846006741 No Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Gorgan, Iran Jamshid Vafaeimanesh j.vafaeemanesh@muq.ac.ir 10031947532846006742 10031947532846006742 Yes Clinical Research Development Center, Qom University of Medical Sciences, Shahid Beheshti Hospital, Shahid Beheshti Boulevard, Qom, Iran