Thoracic endovascular aortic repair for type B intramural hematoma.

A 66-year-old woman presented with sudden onset sharp back pain. Past medical history included hypertension with medication non-compliance, diabetes, hyperlipidemia, obstructive sleep apnea and former tobacco use. She was hypotensive upon arrival with a hemoglobin of 8.1 g/dL, but hemodynamically stabilized with fluid resuscitation. She reported no shortness of breath, gastrointestinal or neurologic symptoms, or trauma. A CT scan revealed extensive descending aortic intramural hematoma (IMH) with posterior hemomediastinum and bilateral hemathoraces. No intimal dissection flap was evident. She underwent emergent thoracic endovascular aortic repair (TEVAR) for type B aortic IMH with rupture.