Abstract
BackgroundThoracic aortic aneurysms, although mostly asymptomatic, are life threatening owing to the risk of rupture. Moreover, the extrinsic pressure of a ruptured aneurysm may encroach the mediastinum.Case presentationA 74-year-old woman diagnosed with ruptured descending thoracic aortic aneurysm compressing the lower trachea and both main bronchi underwent thoracic endovascular aortic repair; however, the extrinsic pressure on the airway persisted. Following failing of endobronchial silicon stents insertion, extracorporeal membrane oxygenation support was required, and endobronchial metallic stents were inserted. The patients’ hypoventilation resolved, and the patient was withdrawn from the ventilator.ConclusionsTechnological improvement in endovascular or endobronchial procedures has provided more options for managing complex cases. However, we must be aware of how high the extrinsic pressure might be before management and take steps to minimize complications.
Highlights
Thoracic aortic aneurysms, mostly asymptomatic, are life threatening owing to the risk of rupture
Thoracic aortic aneurysms are commonly undiagnosed until the appearance of symptoms, and the patient might be fortunate if the symptoms related to aneurysmal enlargement appear and are diagnosed before rupture [1]
The use of endovascular stent grafts has increased owing to development of procedures that have lower risk and are lesser invasive and lesser traumatic than surgical operations for the treatment of thoracic aortic aneurysm [2]
Summary
Mostly asymptomatic, are life threatening owing to the risk of rupture. The use of endovascular stent grafts has increased owing to development of procedures that have lower risk and are lesser invasive and lesser traumatic than surgical operations for the treatment of thoracic aortic aneurysm [2]. In complicated ruptured cases, the extrinsic pressure of the aneurysm may not be relieved with the stent graft, resulting in the need of an additional procedure or a period time for aorta remodeling.
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