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Endovascular treatment of ruptured thoracic aortic aneurysms.

An open surgical procedure with prosthetic vascular graft repair is the conventional treatment for patients with thoracic aortic aneurysm (TAA), although such procedures carry a substantial operative risk related to the major thoracic approach, the use of cardiopulmonary bypass, and such major potential postoperative complications as paraplegia or renal failure. The natural history of TAA in a high proportion of untreated patients is rupture, which invariably results in death. In contrast to the improving results of elective surgery, surgical treatment of ruptured TAA remains technically challenging and gives dismal results, with a mortality of more than 50%.1,2 Recently, several authors have reported the successful treatment of TAA with the implantation of stent grafts.3-5 We report the cases of 7 patients with ruptured TAAs successfully excluded with endoluminal stent grafts.