Zentralblatt fur Chirurgie. 2006 Feb;131(1):8-12. [Link]
R. Rückert1, M. Pirlich2, P. Rogalla3, M. Ismail4, A. Kasper4, H. Gerl2, J. Müller4
1 Chirurgische Klinik, Franziskus-Krankenhaus Berlin
2 Medizinische Klinik mit Schwerpunkt Endokrinologie
3 Institut für Radiologie
4 Klinik für Allgemein-, Viszeral-, Gefäß- und Thoraxchirurgie,
Universitätsmedizin Berlin Charitï¿½, Campus Mitte
Introduction: Endovascular therapy is being used increasingly also to treat ruptured infrarenal aortic aneurysms. Non-traumatic rupture of non-aneurysmatic infrarenal aorta is an absolute rarity.
Methods: The feasibility of endovascular repair of infrarenal aortic rupture is demonstrated with a case history and a literature review.
Results: A 58-year-old male developed spontaneous rupture of his infrarenal aorta after successful chemotherapy resulting in regression of a periaortic tumor. The patient suffered from a sepsis for several days before aortic rupture was discovered during computed tomography for focus search. Immediate endovascular stent-graft repair was performed under emergency conditions. There is no recurrence and the patient is doing well with the stent-graft in place without any pathological finding after a follow-up of 24 months. So far only three further cases have been reported of endovascular repair for penetrating atherosclerotic ulcer with rupture of the infrarenal aorta.
Discussion: This is the first report of endovascular repair of aortic rupture due to successful chemotherapy of a periaortic mesothelioma. Furthermore, this is the fourth case of successful stent-graft placement to treat non-aneurysmatic rupture of the infrarenal aorta. Minimally invasive endovascular therapy should become a standard treatment option for aortic rupture.
Key words: aortic rupture – peritoneal mesothelioma – penetrating atherosclerotic ulcer – endovascular therapy – stent-graft system