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Related Experiment Video

Updated: Apr 4, 2026

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
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Hemothorax Management After Endovascular Treatment For Thoracic Aortic Rupture.

G Piffaretti1, M Menegolo2, A Kahlberg3

  • 1Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|September 13, 2015
PubMed
Summary

Endovascular repair of thoracic aortic rupture (TEVAR) with hemothorax (HTX) has a high mortality rate and persistent respiratory complications. Early HTX drainage may improve survival, but outcomes are similar across different aortic diseases.

Keywords:
HemothoraxRespiratory complicationsTEVARThoracic aortic endovascular repairThoracic aortic rupture

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Thoracic aortic rupture (TAR) management remains challenging, with hemothorax (HTX) posing significant risks.
  • Endovascular aortic repair (TEVAR) has advanced treatment but requires careful assessment of associated complications.

Purpose of the Study:

  • To analyze hemothorax management and respiratory complications following TEVAR for thoracic aortic rupture.
  • To evaluate the impact of TEVAR on survival and respiratory outcomes in patients with HTX.

Main Methods:

  • Multicenter retrospective analysis of 56 patients with confirmed HTX due to descending thoracic aorta rupture treated with TEVAR.
  • Monitoring of respiratory function (acid-base status, Pao2, Paco2, lactate, respiratory index) throughout hospitalization.
  • Primary endpoints included survival and post-operative respiratory complications.

Main Results:

  • TEVAR achieved 100% technical success, with a 12.5% in-hospital mortality rate.
  • Respiratory complications occurred in 41% of patients, leading to longer ICU and hospital stays.
  • Lower pre-operative PO2 was associated with increased respiratory complications; however, outcomes did not differ by aortic pathology.

Conclusions:

  • Thoracic aortic rupture treated with TEVAR still carries a high mortality risk and significant respiratory complications.
  • Hemothorax evacuation may positively influence survival, though outcomes are similar across different aortic pathologies.
  • Respiratory complications remain a challenge post-TEVAR, underscoring the need for vigilant monitoring and management.