Endovascular Treatment of Repeated Multilevel Spontaneous Aortic Ruptures: A Case Report

Abstract

Introduction Approximately 40 cases of spontaneous rupture of the aorta have been described in the literature. Diagnosis can be challenging, and a high index of clinical suspicion enabling prompt treatment can be lifesaving. Report This report presents the case of a 73 year old man who had three multilevel ruptures of the aorta at different times, all treated endovascularly. The patient had a good post-operative course, with no complaints during regular follow up. Discussion Clinical presentation was non-specific because the ruptures were contained, but spontaneous rupture of the aorta can manifest with a catastrophic presentation and hypovolaemic shock, requiring immediate treatment. The endovascular technique used was safe and resolved the patient's symptoms.

Spontaneous contained rupture of the nonaneurysmal ascending aorta: Diagnostic importance of pericardial effusion

“…Therefore, a high index of clinical suspicion is extremely important in patients even without apparent finding such as aneurysm or dissection on computed tomography when effusion is seem. 3,4 The pathology did not show any evidence of etiology of aorta, so we are assuming an acute rupture, contained for the most part by the mediastinal tissues. There may be a fine line between penetrating aortic ulcer and false aneurysm but without observed underlying pathology, an acute event must be entertained.…”

“…Approximately 40 cases of spontaneous aortic rupture have been reported in the literature. 4 A review including 18 cases showed that mean age of patients was 63 years old, and about 70% were male.…”

“…2 In addition, it is difficult to detect this entity on imaging modalities because it does not show specific imaging findings. 3,4 We, herein, present a case of spontaneous contained rupture of nonaneurysmal ascending aorta associated with coronary artery disease (CAD). The only positive finding that there was an acute event was the presence of a pericardial effusion.…”