Endovascular treatment for life-threatening hemoptysis due to rupture of descending thoracic aortic aneurysm: A case series

Anh Tuan Vo; Son Minh Kieu; Nguyen Thoi Hai Nguyen; Truc T T Nguyen; Phuoc Ha Huu Dang; Tuan Duc Ngo

doi:10.1016/j.ijscr.2023.108693

Endovascular treatment for life-threatening hemoptysis due to rupture of descending thoracic aortic aneurysm: A case series

Int J Surg Case Rep. 2023 Sep:110:108693. doi: 10.1016/j.ijscr.2023.108693. Epub 2023 Aug 19.

Authors

Anh Tuan Vo¹, Son Minh Kieu², Nguyen Thoi Hai Nguyen², Truc T T Nguyen³, Phuoc Ha Huu Dang², Tuan Duc Ngo²

Affiliations

¹ Thoracic and Cardiovascular Surgery Department, Dong Nai General Hospital, Viet Nam. Electronic address: dranhtuanvo@gmail.com.
² Thoracic and Cardiovascular Surgery Department, Dong Nai General Hospital, Viet Nam.
³ Translational Medicine Division, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taiwan.

Abstract

Introduction and importance: Aortic aneurysm is an uncommon but life-threatening cause of hemoptysis. Treatments include surgery and/or endovascular intervention, each with its own advantages and disadvantages. Endovascular intervention is associated with good early and medium-term outcomes.

Case presentations: We report three cases of hemoptysis due to ruptured thoracic aortic aneurysm who underwent endovascular intervention. In all three cases, endovascular grafts were placed in the descending thoracic aorta, the number of grafts used was 1, the average time to stop hemoptysis was 4 to 5 days, and the length of hospital stay was between 6 and 8 days. No intravascular fistula, renal failure, prolonged mechanical ventilation and other major cardiovascular events were reported.

Clinical discussion: Endovascular treatment for descending TAA has been demonstrated to be safe and effective, particularly in emergencies in which patients presented with life-threatening hemoptysis, due to its rapid access to the aorta. In our experience at a tertiary hospital in southern Vietnam, the procedural time for a thoracic endovascular aortic repair is relatively brief and can last between 15 and 30 min. Thus, endovascular treatment for ruptured TAA can substantially improve patient prognosis, reduce mortality and complications.

Conclusion: The implementation of endovascular intervention can help improve prognosis, reduce mortality and complications in patients with hemoptysis due to ruptured thoracic aortic aneurysm.

Keywords: Endovascular; Hemoptysis; Ruptured aortic aneurysm.