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Harky et al. Vessel Plus 2018;2:8 Vessel Plus
DOI: 10.20517/2574-1209.2018.12

Review Open Access

Ruptured isolated descending thoracic aortic
aneurysm: open or endovascular repair?

Amer Harky , Nichola Manu , Rafal Al Nasiri , Dilan Sanli , Ciaran Grafton-Clarke , Jeffrey Shi Kai Chan ,
6
5
4
3
1
1,2
Chris Ho Ming Wong 6
1 Department of Vascular Surgery, Countess of Chester Hospital, Chester CH2 1UL, UK.
2 School of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
3 Department of General Surgery, Countess of Chester Hospital, Chester CH2 1UL, UK
4 Faculty of Medicine, Bulent Ecevit University, Zonguldak 67100, Turkey.
5 School of Medicine, University of Liverpool, Liverpool L69 3GE UK.
6 Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Correspondence to: Dr. Amer Harky, Department of Vascular Surgery, Countess of Chester Hospital, Chester CH2 1UL, UK.
E-mail: aaharky@gmail.com
How to cite this article: Harky A, Manu N, Al Nasiri R, Sanli D, Grafton-Clarke C, Chan JSK, Wong CHM. Ruptured isolated
descending thoracic aortic aneurysm: open or endovascular repair? Vessel Plus 2018;2:8.
http://dx.doi.org/10.20517/2574-1209.2018.12
Received: 18 Mar 2018 First Decision: 9 Apr 2018 Revised: 27 Apr 2018 Accepted: 3 May 2018 Published: 7 May 2018

Science Editor: Nikolaos Patelis, Mario F. L. Gaudino Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Descending thoracic aortic aneurysm management has gained momentum and became a topic of many debates at
international levels since the evolution of endovascular repair. Ruptured descending thoracic aortic aneurysm is a
clinical emergency which is associated with high mortality and morbidity rates if not managed properly. Prior to thoracic
endovascular aortic repair (TEVAR), open repair (OR) was the gold standard management, however since the evolution
of TEVAR, this has changed. Several centers have reported many of their experiences and published that TEVAR can
provide equal or even better perioperative outcomes when compared to OR, although the evidences can be of only short
term and could be biased at different levels at the time of publication. This review article is aimed to examine current
literature evidences behind the use of TEVAR vs. OR and the reported comparative clinical outcomes.

Keywords: Open repair, aorta, endovascular repair, ruptured aorta, descending thoracic aorta

INTRODUCTION
Descending thoracic aortic aneurysm (DTAA) is a clinical entity that gained a lot of international attention
in the current era. Currently, the presence of such aneurysms is mandated for elective repair to prevent

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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