Treatment of Ruptured Thoracic Aortic Aneurysm of the Descending Aorta

Rupture of a thoracic aortic aneurysm is a surgical emergency. The choice of repair strategy depends on the patient's anatomy, and the preferred approach is determined before any intervention.

Clinical Scenario

Patients presenting with rupture of a descending thoracic aortic aneurysm require urgent surgical assessment. The principal decision is whether the anatomy allows for endovascular repair or requires open surgery.

Approach to Repair

For anatomic candidates, endovascular repair of the descending thoracic aorta is the preferred intervention, recommended over open surgical repair on the basis of reduced perioperative death and morbidity. In selected cases, coverage of adjacent arterial branches may be considered to optimize the technical result.

Full protocol details — including anatomic criteria, procedural specifics, and open repair guidance — are available via the structured regimen below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1161/CIR.0000000000001106

In patients with ruptured descending TAA who are anatomic candidates for endovascular repair, TEVAR is recommended over open repair because of decreased perioperative death and morbidity.

In patients with ruptured descending TAA undergoing TEVAR, intentional coverage of the left subclavian artery, celiac artery, or both may be considered to increase the landing zone for endovascular repair.

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