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2015 ; 32
(3
): 249-58
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Emergent Endovascular Stent Grafts for Ruptured Aortic Aneurysms
#MMPMID26327743
Montgomery JP
; Kolbeck KJ
; Kaufman JA
Semin Intervent Radiol
2015[Sep]; 32
(3
): 249-58
PMID26327743
show ga
Ruptured aortic aneurysms uniformly require emergent attention. Historically,
urgent surgical repair or medical management was the only treatment options. The
development of covered stent grafts has introduced a third approach in the care
of these critical patients. The clinical status of the patient and local
physician expertise drive the treatment modalities in the majority of cases. The
goal of therapy in these patients is to stabilize the patient as quickly as
possible, establish maximum survival with minimum morbidity, and provide a long
lasting result. The endovascular approach has become an acceptable treatment
option in an increasing number of patients presenting with ruptured aneurysmal
disease of both the descending thoracic and abdominal aorta. Major factors
influencing treatment include patient clinical status, characteristics of the
aorta, physician preference, institutional experience, and availability of
appropriate equipment. Planning, experience, and the ability to improvise
effective solutions are keys to the success of the procedure when endovascular
techniques are utilized. Three separate cases, requiring intraprocedural
improvisation, are presented followed by a review of the literature.