Simultaneous endovascular repairs of concomitant ruptured abdominal aortic aneurysm and huge silent thoracic aortic aneurysm.

Ruptured abdominal aortic aneurysm (rAAA) is an emergent condition that carries higher mortality rate. Although there had been development of interventional and surgical technique besides improved critical care, mortality rates were still varied between 35 and 53% in the reported series. Preoperative shock was reported as a major factor predicting mortality rate. Feasibility of simultaneous endovascular repair of rAAA and silent thoracic aortic aneurysm (TAA) is not known. Herein, we aimed to demonstrate the advantage of simultaneous endovascular repair of rAAA and silent TAA in the settling of hemodynamic and neurologic instability. We proposed that simultaneous repair of silent aneurysm would eliminate second procedural risk and also further rupture risk, especially in high-risk patients.