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Case Reports
. 2016 Oct-Dec;15(4):322-327.
doi: 10.1590/1677-5449.006716.

TEVAR for ruptured descending thoracic aortic aneurysm: case report

Sthefano Atique Gabriel  1 , Enrico Rinaldi  2 , Marco Leopardi  2 , Germano Melissano  2 , Roberto Chiesa  2
Affiliations
Case Reports

TEVAR for ruptured descending thoracic aortic aneurysm: case report

Sthefano Atique Gabriel et al. J Vasc Bras. 2016 Oct-Dec.

Abstract
in English, Portuguese

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).

O aneurisma roto de aorta torácica descendente constitui uma situação ameaçadora associada a alta morbidade e mortalidade. O tratamento endovascular desse tipo de aneurisma promove exclusão eficaz com uma terapêutica minimamente invasiva. Os autores relatam o caso de um paciente do sexo masculino, 76 anos, hemodinamicamente instável, com aneurisma roto de aorta torácica descendente de 9 cm de diâmetro, tratado em caráter emergencial por cirurgia endovascular.

Keywords: endovascular procedures; ruptured aneurysm; thoracic aortic aneurysm.

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Conflict of interest statement

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Figures

Figure 1
Figure 1. Preoperative CT MultiPlanar Reconstruction showing a 9-cm (line) ruptured descending thoracic aortic aneurysm with short and angulated proximal landing zone (upper asterisk) and an unclear and angulated distal landing zone (lower asterisk).
Figure 2
Figure 2. Preoperative CT-scan. (A) Axial view with periaortic hematoma (arrow); (B) Sagittal view with the possible point of descending thoracic aortic rupture indicated (arrow).
Figure 3
Figure 3. Intraoperative aortography with evidence of the descending thoracic aortic aneurysm (arrow).
Figure 4
Figure 4. Videothoracoscopy. (A) Blood clot in the left pleural cavity; (B) Mechanical removal of the blood clot; (C) Complete aspiration of the blood in the left pleural cavity; (D) Left lung mobilization with thoracic aorta exposure (arrow), the thoracic aorta is completely excluded without any sign of residual bleeding.
Figure 5
Figure 5. Postoperative CT scan showing correctly positioned endograft.
See this image and copyright information in PMC

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