[Endovascular therapy of non-aneurysmatic infrarenal aortic rupture].
BACKGROUND
Endovascular therapy is being used increasingly also to treat ruptured infrarenal aortic aneurysms. Non-traumatic rupture of non-aneurysmatic infrarenal aorta is an absolute rarity.


METHODS
The feasibility of endovascular repair of infrarenal aortic rupture is demonstrated with a case history and a literature review.


RESULTS
A 58-year-old male developed spontaneous rupture of his infrarenal aorta after successful chemotherapy resulting in regression of a periaortic tumor. The patient suffered from a sepsis for several days before aortic rupture was discovered during computed tomography for focus search. Immediate endovascular stent-graft repair was performed under emergency conditions. There is no recurrence and the patient is doing well with the stent-graft in place without any pathological finding after a follow-up of 24 months. So far only three further cases have been reported of endovascular repair for penetrating atherosclerotic ulcer with rupture of the infrarenal aorta.


CONCLUSIONS
This is the first report of endovascular repair of aortic rupture due to successful chemotherapy of a periaortic mesothelioma. Furthermore, this is the fourth case of successful stent-graft placement to treat non-aneurysmatic rupture of the infrarenal aorta. Minimally invasive endovascular therapy should become a standard treatment option for aortic rupture.
Chirurgische Klinik, Franziskus-Krankenhaus Berlin, Akademisches Lehrkrankenhaus der Charité, Universitätsmedizin Berlin, Budapester Strasse 15-19, 10787 Berlin. rir-chirurgie@franziskus-berlin.de
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R
Rückert
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M
Pirlich
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P
Rogalla
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M
Ismail
A
A
Kasper
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H
Gerl
J
J
Müller
D000800:Angioplasty, Balloon / Q000379:methods*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000628:therapy*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D004630:Emergencies; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy; D018805:Sepsis / Q000150:complications / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis; D015607:Stents; D014057:Tomography, X-Ray Computed