Emergency Endovascular Treatment of Traumatic Aortic Arch Rupture with Multiple Arch Vessel Involvement

Abstract

Purpose:

To report successful endovascular stent-graft placement for emergency treatment of a complex traumatic injury involving the aortic arch and multiple arch vessels.

Case Report:

An 81-year-old man underwent stent-graft placement for a complex traumatic vascular injury. Computed tomography on admission documented a dissection along the course of the aortic arch, intramural hematoma along the ascending aorta, dissection of the innominate artery, and a right subclavian artery pseudoaneurysm. The dissection of the aortic arch and the pseudoaneurysm of the right subclavian artery were treated immediately, the dissection of the innominate artery 7 days later. The patient did not develop any complications. Follow-up studies performed prior to discharge and at 6 and 12 months after the interventions showed successful repair of the complex vascular injuries.

Conclusions:

Traumatic injury of the aortic arch with multiple arch vessel involvement can be treated effectively by means of stent-graft placement.

Keywords

aortic arch deceleration injury aortic rupture intramural hematoma innominate artery subclavian artery dissection pseudoaneurysm stent-graft

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