Emergent endovascular interventions for contained rupture of thoracic aortic aneurysms

The purpose of our study was to assess in an emergency setting the feasibility of endovascular stent graft treatment of contained ruptures of thoracic aortic aneurysms.

Seven patients with contained ruptures of thoracic aortic aneurysms from a series of 54 endovascular interventions were treated by the deployment of an aortic stent graft. In all cases, hemothorax was present. Acute deployment was performed with the patient under general anesthesia, and access was gained via the common femoral or iliac arteries. After a follow-up o f 12 months, the patients were evaluated by computed tomography.

One patient died perioperatively. The procedure was technically successful in 5 patients. Perioperatively and at follow-up, there were no cases of paraplegia, stent graft migration, or endoleaks. There were, however, 2 cases of access failure, 1 case of temporary renal failure, and 2 patients who required prolonged mechanical ventilation.

The acute treatment of contained ruptures of thoracic aortic aneurysms is feasible. This form of treatment seems to be a promising option in the treatment of these high-risk patients.