Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Oncology

Background:

• Spontaneous non-aneurysmal aortic rupture is a rare condition often misdiagnosed due to the absence of an aneurysm.
• Diagnosis is challenging, particularly in elderly patients presenting with non-specific symptoms like back pain and weight loss.

Observation:

• An 85-year-old male presented with symptoms suggestive of malignancy, undergoing oncological investigation.
• Previous imaging revealed a contained pseudoaneurysm of the infrarenal aorta with aortoiliac calcification.
• During staging computed tomography, a contained rupture of the infrarenal aorta was critically identified.

Findings:

• The patient underwent urgent endovascular repair using an aortic cuff endoprosthesis.
• The procedure was technically successful with no immediate complications.
• Postoperative imaging confirmed successful repair and absence of endoleaks at 6 months.

Implications:

• This case underscores the critical importance of interdisciplinary communication between radiology and clinical teams for accurate diagnosis.
• Prompt identification of aortic rupture, even in a non-aneurysmal aorta, allows for timely and effective endovascular intervention.
• Successful endovascular repair in this rare scenario demonstrates its feasibility and potential to reduce procedure time and complications.