Thoracic Endovascular Aortic Repair for Embolizing Total Occlusion of the Descending Aorta due to Aortic Sarcoma

Primary malignant tumors of the aorta are extremely rare, and the diagnosis is difficult from the clinical onset. Accordingly to the principles of cancer surgery, “en bloc” resection of the tumor-involved aorta and graft interposition is the gold standard, but it is still technically challenging and comorbidities may rule out some patients from an operative treatment. Thoracic endovascular aortic repair has been reported anecdotally, but it is an ease and rapid alternative in urgent circumstances and proved to be effective to relieve symptoms caused by these lesions. Unfortunately, no matter what is the type of histology or immunohistochemistry, or the type of treatment, the prognosis of aortic malignancies is very poor. Nevertheless, an operative treatment strategy which includes surgical resection and chemotherapy or radiation had long survival than patients treated with a single modality. We report a case of acute mesenteric syndrome caused by an occlusive and embolizing thrombus of the descending thoracic aorta caused by primary aortic sarcoma treated with thoracic endovascular aortic repair.