TEVAR for ruptured descending thoracic aortic aneurysm: case report

Abstract

A ruptured descending thoracic aortic aneurysm (rDTAA) is a life-threatening condition associated with high morbidity and mortality. Endovascular treatment for rDTAA promotes effective aneurysm exclusion with a minimally invasive approach. The authors report a case of a 76-year-old man with hemodynamically unstable 9-cm-diameter rDTAA treated with emergency thoracic endovascular aortic repair (TEVAR).

Wrapping of ascending aortic aneurysm with supra‐aortic debranching and endovascular repair for aortic arch aneurysm and ruptured descending thoracic aortic aneurysm

“…Ruptured descending thoracic aorta aneurysm (DTAA) accounts for approximately 30% of all thoracic aortic ruptures and is a life‐threatening condition associated with very high rates of morbidity and mortality . The endovascular management of ruptured DTAA, apart from being less invasive than open repair, enables aneurysm exclusion without thoracotomy and aortic clamping .…”

Ruptured isolated descending thoracic aortic aneurysm: open or endovascular repair?

“…Just over a decade ago, the gold standard management of rDTAA was open repair (OR) requiring thoracotomy, aortic cross-clamping, aneurysm resection and replacement with an interposition of a prosthetic graft and cardiopulmonary bypass [2][3][4] . However, ORs were associated with high perioperative mortality and neurological adverse events [5] ; nevertheless with advancement in clinical practice and evolving minimal access surgical interventions, the role of endovascular repair in such emergencies has been explored.…”

“…Thoracic endovascular aortic repair (TEVAR) has appealing qualities including a minimally invasive procedure with rapid deployment with decreased operative time and decreased blood loss [3] . However, this approach is subject to anatomical and logistical limitations, including anatomical requirements and variations, the quality of the landing zones, ease of iliac access, availability of the wide range of stent graft sizes in an emergency setting and available expertise on site [4] . The major benefits of endovascular repair reported are lower mortality and morbidity rates associated with such a complex procedure [5] .…”