Emergency Endografting for Spontaneous Thoracic Aortic Rupture

Abstract

Spontaneous rupture of the thoracic aorta is rare. We present a 76-year-old man who developed spontaneous rupture of the aortic arch associated with massive periaortic hematoma and hypovolemic shock. Because the site of rupture could not be identified, emergency hybrid endovascular aortic repair to shield a long segment of the aorta was performed according to the extent and density of periaortic hematoma on axial CT scans. His blood pressure improved just after deployment of the endograft. Rapid diagnosis by CT and prompt control of aortic hemorrhage by endografting salvaged this patient. Three-dimensional (3D) volume-rendered CT images are useful for identifying the site of aortic rupture, but may not be available in an emergency.

Endovascular Treatment of Repeated Multilevel Spontaneous Aortic Ruptures: A Case Report

“…Additionally, if the bleeding site cannot be clearly identified, the endoprosthesis is capable of sealing a long segment of the aorta, extending distally if necessary. The proximal portion is more challenging because it requires branches, fenestrations, or hybrid procedures in some cases 8 . Recently, endovascular repair has even been applied to a case of spontaneous early postpartum distal aortic arch rupture (with no dissection), which was successfully treated with a good mid term result 9 .…”