Hybrid Surgery for Thoracic Aneurysm Rupture: An Effective Alternative in a Case Without Distal Neck

Introduction: Endovascular treatment of descending thoracic aortic aneurysms (DTAA) is associated with low rates of morbidity and mortality and is currently the first line of therapeutic intervention. Endoleaks are a well known complication of this technique, with the consensus that the identification of type I endoleak implies its prompt correction. Report: This is the report of a patient who underwent TEVAR for the treatment of DTAA, with exclusion of the aneurysm on follow up angiography. Follow up CTA showed type Ib endoleak with aneurysm sac growth, so treatment was proposed which the patient refused. The patient was subsequently admitted urgently with rupture of the aneurysm and was immediately subjected to debranching of the visceral trunks, followed by distal TEVAR extension. Discussion: Hybrid treatment of thoracic aneurysms without a distal landing zone through debranching of the visceral trunks and TEVAR is an alternative to conventional surgery and complex endovascular surgery, which presents good results in patients with high surgical risk and also allows treatment of patients urgently as it does not depend on the manufacture of fenestrated and/or branched endoprostheses. Keywords: Debranching, Descending thoracic aortic aneurysm, Endoleak, Hybrid surgery, TEVARView Large Image Figure ViewerDownload Hi-res image Download (PPT)