Endovascular repair of ruptured saccular aneurysms of the descending thoracic aorta.
Open repair of ruptured aneurysms of the descending thoracic aorta (DTA) is associated with early mortality rates of 20%-60% and severe morbidity rates exceeding 40%. The present report describes three octogenarian patients and one sexagenarian patient at poor surgical risk admitted with acutely ruptured saccular DTA aneurysms (two of four were anastomotic) unrelated to trauma or infection who underwent successful endovascular therapy, which involved the use of aortic endovascular cuffs in three cases. Mean intensive care unit and total hospital stay durations were 1.75 days (range, 1-4 d) and 6 days (range, 3-13 d), respectively. At 30 days, all patients were alive and free of repeat intervention, with aneurysm exclusion achieved in all cases but one, which featured a marginal type II endoleak. These data support endovascular therapy for ruptured saccular DTA aneurysms enabling short-term outcomes that otherwise would have been unrealistic.
Delis
Konstantinos T
KT
Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA.
Gloviczki
Peter
P
Bjarnason
Haraldur
H
Sullivan
Timothy M
TM
McKusick
Michael A
MA
Kalra
Manju
M
Bower
Thomas C
TC
D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012422:Rupture, Spontaneous; D015607:Stents; D016896:Treatment Outcome