title: Thoracic Endovascular Aortic Repair for Embolizing Total Occlusion of the Descending Aorta due to Aortic Sarcoma.
abstract: Primary malignant tumors of the aorta are extremely rare, and the diagnosis is difficult from the clinical onset. Accordingly to the principles of cancer surgery, "en bloc" resection of the tumor-involved aorta and graft interposition is the gold standard, but it is still technically challenging and comorbidities may rule out some patients from an operative treatment. Thoracic endovascular aortic repair has been reported anecdotally, but it is an ease and rapid alternative in urgent circumstances and proved to be effective to relieve symptoms caused by these lesions. Unfortunately, no matter what is the type of histology or immunohistochemistry, or the type of treatment, the prognosis of aortic malignancies is very poor. Nevertheless, an operative treatment strategy which includes surgical resection and chemotherapy or radiation had long survival than patients treated with a single modality. We report a case of acute mesenteric syndrome caused by an occlusive and embolizing thrombus of the descending thoracic aorta caused by primary aortic sarcoma treated with thoracic endovascular aortic repair.
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy. Electronic address: gabriele.piffaretti@uninsubria.it.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Ferraro
authors.affiliation: Interventional Radiology, and Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
authors.affiliation: Interventional Radiology, and Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Macchi
authors.affiliation: Anesthesia and Palliative Care, Circolo University Hospital, Varese, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bacuzzi
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Castelli
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000209:etiology / Q000601:surgery; D008641:Mesenteric Vascular Occlusion / Q000209:etiology / Q000601:surgery; D011474:Prosthesis Design; D012509:Sarcoma / Q000150:complications* / Q000473:pathology; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000150:complications* / Q000473:pathology