Spontaneous rupture of the thoracic aorta without trauma, aneurysm or dissection is a rare but fatal disease. We reported successful endovascular aortic repair of thoracic aortic spontaneous rupture in 3 patients. Generally, it is difficult to accurately identify the rupture site in the spontaneous rupture. However, by detailed planning based on the data of preoperative CT images, thoracic endovascular aortic repair (TEVAR) can be successfully performed, like surgical repair of spontaneous rupture of the distal aortic arch or descending thoracic aorta. TEVAR should be considered as a first-line therapy, especially, in patients with advanced age or significant comorbidities.
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