The authors report their experience with endovascular treatment of a 73-year old woman with ruptured thoracic aortic aneurysm. The patient was treated on emergency basis 4 hours after CT diagnosis of hemorrhage. The tubular, thoracic stent-graft was implanted across the rupture site from surgical cut down of the right femoral artery. Immediately after the procedure the patient became hemodynamically stable and follow-up CT proved appropriate position of the stent-graft without sign of active extravasation. In spite of intensive care therapy respiratory and urine infection progressively developed and the patient died 49th day after the endovascular treatment due to septic shock. Necropsy confirmed correctly placed stent-graft across the rupture site, there was no sign of infection in the adjacent mediastinal heamatoma. Acute thoracic rupture represents serious affection, which is almost invariably fatal, if left untreated. Conventional open surgery, using cardiopulmonary bypass, still has a high mortality rate, can be as high as 50 %, when it is performed on an urgent basis. Endovascular stent-graft placement is emerging as a promising treatment alternative to open surgery for patients with descending thoracic aortic diseases. Very promising mid-term results were achieved in stent-graft treatment of traumatic aortic rupture. Aortic rupture due to the thoracic aneurysm or dissection, even with minimally invasive endovascular repair can be associated with high mortality.

        Key words: aorta – rupture – stent-graft – endovascular therapy