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

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.