title: Thoracic endovascular aortic repair for ruptured descending thoracic aortic aneurysm.
abstract: BACKGROUND
  We evaluated clinical outcomes of thoracic endovascular aortic repair (TEVAR) for ruptured descending thoracic aortic aneurysm (rDTAA).
  
  
  METHODS
  Twenty-three patients with rDTAA (mean age, 76.8 ± 8.8 years) underwent TEVAR at our center between January 2008 and April 2013.
  
  
  RESULTS
  In twenty-three patients, five patients (21.7%) were in shock before surgery. Technical success was achieved in 21 patients. After TEVAR, retrograde Type A aortic dissection occurred in one patient, Type I endoleak in one patient, and Type II endoleak in three patients. The 30-day mortality rate was 4.3% (n = 1), and there were five in-hospital deaths (21.7%). Six patients (26.1%) developed cerebral complications and two patients suffered from paraplegia. In the late phase, four patients died because of the following aortic events: re-rupture in one patient, rupture of another untreated aneurysm in two patients, and esophageal perforation in one patient.
  
  
  CONCLUSIONS
  TEVAR is associated with relatively low early morbidity and mortality and can be performed in older and high-risk patients. However, because aortic events during follow-up after TEVAR are not rare, we recommend close follow-up and application of early and aggressive reintervention.
authors.affiliation: Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan; Cardiovascular Surgery, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Minami
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Imoto
authors.forename: Keiji
authors.initials: K
authors.lastname: Uchida
authors.forename: Norihisa
authors.initials: N
authors.lastname: Karube
authors.forename: Shota
authors.initials: S
authors.lastname: Yasuda
authors.forename: Tomoki
authors.initials: T
authors.lastname: Choh
authors.forename: Shinichi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009026:Mortality; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome