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Abstract

Purpose:

To present initial experience with emergent stent-graft placement for impending rupture of the descending thoracic aorta.

Case Reports:

Intramural hematoma (IMH) of the descending thoracic aorta was diagnosed by transesophageal echocardiography and computed tomography in 3 patients with acute onset of severe thoracic pain. Because of signs of impending rupture, e.g., pleural effusion, sustained pain, or transadventitial bleeding, the patients underwent emergency stent-graft placement, which was successful in all cases. No procedure-related complications were observed. Follow-up to 18 months has revealed no evidence of endoleak, and all patients remain free of symptoms.

Conclusions:

Emergency stent-graft placement may be a promising alternative to conventional surgery in patients with impending aortic rupture due to IMH.

Keywords

endovascular repair intramural hematoma aortic dissection pleural effusion Talent stent-graft

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References

Svensson

Labib

Eisenhauer

. Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. Circulation. 1999;99:1331–1336.

Mohr-Kahaly

Erbel

Kearney

. Aortic intramural hemorrhage visualized by transesophageal echocardiography: findings and prognostic implications. J Am Coll Cardiol. 1994;23:658–664.

Nienaber

von Kodolitsch

Petersen

. Intramural hemorrhage of the thoracic aorta. Diagnostic and therapeutic implications. Circulation. 1995;92:1465–14672.

von Kodolitsch

Nienaber

. Intramural hemorrhage of the thoracic aorta: diagnosis, therapy and prognosis of 209 in vivo diagnosed cases [in German]. Z Kardiol. 1998;87:797–807.

Maraj

Rerkpattanapipat

Jacobs

. Meta-analysis of 143 reported cases of aortic intramural hematoma. Am J Cardiol. 2000;86:664–668.

Moriyama

Yotsumoto

Kuriwaki

. Intramural hematoma of the thoracic aorta. Eur J Cardiothorac Surg. 1998;13:230–239.

Griepp

Ergin

Galla

. Looking for the artery of Adamkiewicz: a quest to minimize paraplegia after operations for aneurysms of the descending thoracic and thoracoabdominal aorta. J Thorac Cardiovasc Surg. 1996;112:1202–1215.

Von Segesser

Geoni

Kunzli

. Surgery for ruptured thoracic and thoraco-abdominal aortic aneurysms. Eur J Cardiothorac Surg. 1996;10:996–1002.

Dake

Miller

Semba

. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med. 1994;331:1729–1734.

10.

Nienaber

Fattori

Lund

. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement. N Engl J Med. 1999;340:1539–1545.

11.

Vilacosta

San Roman

Ferreiros

. Natural history and serial morphology of aortic intramural hematoma: a novel variant of aortic dissection. Am Heart J. 1997;134:495–507.

12.

Keren

Kim

. Accuracy of biplane and multiplane transesophageal echocardiography in diagnosis of typical acute aortic dissection and intramural hematoma. J Am Coll Cardiol. 1996;28:627–636.

13.

Erbel

Alfonso

Boileau

. Diagnosis and management of aortic dissection. Eur Heart J. 2001;22:1642–1681.

14.

Dake

. Endovascular stent-graft management of thoracic aortic diseases. Eur J Radiol. 2001;39:42–49.

15.

Tiesenhausen

Amann

Koch

. Cerebrospinal fluid drainage to reverse paraplegia after endovascular thoracic aortic aneurysm repair. J Endovasc Ther. 2000;7:132–135.

Emergency Stent-Graft Placement for Impending Rupture of the Descending Thoracic Aorta

Abstract

Purpose:

Case Reports:

Conclusions:

Keywords

Get full access to this article

References