Right-sided hemothorax after endovascular exclusion of descending thoracic aortic aneurysms with contained rupture

Endovascular treatment of descending thoracic aortic (DTA) aneurysms seems to offer satisfactory early and midterm results with lower mortality and morbidity compared to open repair. The authors report three cases of right-sided hemothorax which is an uncommon complication after DTA endografting for a contained rupture. Three patients presented right hemothorax after endografting for DTA aneurysm with contained rupture. The patients were treated by means of right pleural cavity evacuation, which was associated in two patients to re-endografting for a type I and III endoleak. One patient, because of the absence of endoleaks, was treated only with chest tube drainage. The patients had good early outcome with complete recovery. The right-sided hemothorax after endovascular treatment of DTA aneurysm is an uncommon but life-threatening complication. The mechanisms responsible for the aneurysm rupture in the right pleural cavity after its exclusion are not completely clear. Nevertheless the persistent pressurization of the aneurysm caused by an high-flow endoleaks should be quickly resolved