title: Plug the Hole--A Bailout Option for Acute Focal Aortic Rupture.
abstract: BACKGROUND
  Focal aortic rupture may result from expanding aneurysms, penetrating aortic wall ulcerations, or virulent infections. An urgent repair of paravisceral focal aortic rupture is associated with high morbidity. A staged repair approach may provide an alternative option.
  
  
  METHODS
  A 64-year-old woman presented with acute focal rupture of the posterior paravisceral aortic wall and was progressing to hemorrhagic shock and mesenteric ischemia. Given the patient's dire condition, an endovascular approach was used to plug her focal aortic wall defect using a ventricular septal defect occluder device. Subsequently, the patient underwent resuscitation, stabilization, and operative exploration. Postoperatively, she recovered well from this staged approach.
  
  
  CONCLUSIONS
  This case provides an example of a staged endovascular plugging of an acute paravisceral focal aortic rupture. In select cases, this type of repair strategy is feasible, until off-the-shelf endovascular repair options become a reality.
authors.affiliation: Department of Surgery, Section of Vascular Surgery, Washington University School of Medicine, St. Louis, MO; Department of Surgery, Division of Vascular Surgery, Veterans Affairs St. Louis Health Care System, St. Louis, MO. Electronic address: zayedm@wustl.edu.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Zayed
authors.affiliation: Division of General Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Clement
authors.initials: C
authors.lastname: Marshall
authors.affiliation: Department of Cardiac Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Dake
authors.affiliation: Division of Vascular Surgery, Stanford University Medical Center, Stanford, CA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Lee
mesh_terms: D001019:Aortic Rupture / Q000175:diagnosis* / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D055989:Septal Occluder Device