Endovascular management options and techniques for ruptured thoracoabdominal aortic aneurysm
Bibliographic record
Abstract
Objective Open surgical repair of ruptured thoracoabdominal aortic aneurysm (rTAAA) carries significant risk of mortality and morbidity; in the recent years, endovascular repair has emerged as a suitable alternative. This article aims to review current available technologies, techniques, and outcomes for endovascular repair of rTAAA. Methods A narrative review of current literature was performed. Results Off-the-shelf branched endografts are available and are often the first-line endovascular therapy for type I-III rTAAA or type IV rTAAA with a lumen diameter ≥ 24 mm at the level of the reno-visceral vessels. In patients with unsuitable anatomy for off-the-shelf branch devices, particularly those with ruptured type IV or pararenal TAAA with narrow aortic lumen, endovascular repair with in-situ laser fenestration is a reasonable alternative. Physician-modified devices as well as endovascular repair with parallel stent grafts (chimney, periscope, sandwich, or Octopus) has been described by select centers with satisfactory outcomes. Conclusions Patients with rTAAA and suitable anatomy who are at high- or prohibitive-surgical risk can be managed endovascularly with comparative outcomes. Various techniques are described in the literature, and the choices of technique used should depend on patient anatomy and surgeon expertise.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".