Emergent Endovascular Treatment of Thoracoabdominal Aortic Rupture in Behcet's Disease

Ann Vasc Surg. 2018 Feb:47:282.e7-282.e11. doi: 10.1016/j.avsg.2017.09.014. Epub 2017 Sep 23.

Abstract

Background: Aortic rupture in Behcet's disease is associated with high mortality rates. Endovascular approach with parallel graft technique can be a valid solution in emergency setting for the treatment of thoraco-abdominal aorta involvement in Behcet's disease.

Methods: We describe the clinical case of a 41-year-old man, urgently hospitalized for a rupture of thoraco-abdominal aorta with occlusion of the celiac trunk and involvement of superior mesenteric artery. The patient also presented a massive right hemothorax and a massive left pulmonary thromboembolism. An aortic endoprosthesis was deployed from the third bottom of the thoracic aorta to the origin of the renal arteries. Parallel stent-graft technique was used to preserve the patency of the superior mesenteric artery. The procedure was performed with local anaesthesia due to the critical conditions of the patient. The patient was discharged in good clinical conditions.

Results: The angio-computed tomography performed 6 months after surgery showed good deployment of the endoprosthesis and patency of the superior mesenteric artery.

Conclusion: In high risk for surgery patients, endovascular treatment with parallel stent graft of thoraco-abdominal aorta rupture is safe and feasible.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anesthesia, Local
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / etiology
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / etiology
  • Aortic Rupture / surgery*
  • Aortography / methods
  • Behcet Syndrome / complications*
  • Behcet Syndrome / diagnosis
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Computed Tomography Angiography
  • Emergencies
  • Endovascular Procedures* / instrumentation
  • Humans
  • Male
  • Pulmonary Embolism / etiology
  • Stents
  • Treatment Outcome