Thoracic Endovascular Aneurysm Repair and Tracheal Stenting for Respiratory Failure due to a Thoracic Aortic Aneurysm: A Case Report

Vasc Endovascular Surg. 2022 Jul;56(5):514-516. doi: 10.1177/15385744221085814. Epub 2022 Apr 1.

Abstract

An 82-year-old male was referred to the emergency department for severe respiratory distress. Computed tomography angiography showed tracheal compression due to a large ruptured saccular aneurysm of the descending thoracic aorta. Emergency Thoracic Endovascular Aneurysm Repair (TEVAR) was performed. To reduce tracheal compression, an endotracheal stent was placed (silicone Dumon©). Following surgery, respiratory function improved. Two days after the surgery, the patient refused further invasive treatment, including mechanical mucus aspiration from the endotracheal stent, and palliative sedation was initiated. Conventional treatment to reduce tracheal compression by a saccular aortic aneurysm is open surgical aneurysm repair. If open repair is contraindicated because of patient age, comorbidity, or in case of severe hemodynamic instability following aneurysm rupture, TEVAR with endotracheal stent placement may serve as a bridge to definite surgery to reduce tracheal compression.

Keywords: aortic aneurysm; respiratory insufficiency; tracheal compression.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Aortic Aneurysm, Abdominal* / surgery
  • Aortic Aneurysm, Thoracic* / complications
  • Aortic Aneurysm, Thoracic* / diagnostic imaging
  • Aortic Aneurysm, Thoracic* / surgery
  • Blood Vessel Prosthesis Implantation*
  • Endovascular Procedures* / methods
  • Humans
  • Male
  • Respiratory Insufficiency* / surgery
  • Stents
  • Treatment Outcome