Ruptured Thoracic Aortic Aneurysm
Type
ModificationConfidence
92%
Created
Apr 15, 2026
Evidence
1 source
Rationale
The stale ESVS 2017 guideline citation riambau 2017 has been replaced by the superseding ESVS 2026 Clinical Practice Guidelines European Society for Vascular Surgery (ESVS), which covers the same claim regarding TEVAR preference over open repair for ruptured descending thoracic aneurysm when anatomy permits. Per the stale guideline replacement instructions, both citations are not retained since they support the same claim and the newer guideline supersedes the older one. The LSA abbreviation was also expanded on first use in this section.
Evidence
These 2025 ESVS clinical practice guidelines provide comprehensive and up to date advice to physicians and patients on the management of diseases of the mesenteric and renal arteries and veins.
Content Changes
* **Ruptured [[TAA]]:** very high early mortality; thoracic endovascular aortic repair (TEVAR) is preferred for descending rTAA when anatomically feasible due to lower perioperative morbidity vs open repair; open repair for unsuitable anatomy, infection, or genetic aortopathy. * **Technical:** Rapid proximal seal; intentional LSAleft subclavian artery (LSA) coverage acceptable in emergencies with planned revascularization when indicated; apply spinal cord protection principles as feasible. For vascular trauma management principles, see [[endovascular trauma management (EVTM)]]. Observational outcomes literature and guideline statements generally favor TEVAR over open repair for ruptured descending thoracic aneurysm when anatomy permits, acknowledging selection bias and the need for rapid hemorrhage control. [@jonker2010] [@riambau2017][@esvs2025] [@erbel2014]