Endovascular repair of the aorta using TEVAR after a traffic accident injury of the descending aorta

    Authors

    Keywords

    rupture of the descending aorta, thoracic endovascular aortic repair, endovascular procedure, catheterization laboratory

    DOI

    https://doi.org/10.15836/ccar2018.63

    Full Text

    **Introduction**: In the beginning, Thoracic Endovascular Aortic Repair (TEVAR) procedure with the insertion of an endovascular stent-graft in the aorta was used for the repair of degenerative aneurysms of the descending aorta, but afterwards the indications for the procedure include the whole spectrum of descending aorta pathology, and traumatic rupture. (1-3) **Case report**: 28-years-old male driver of a family car, who was injured in a car crash, was brought into the surgical emergency department by first aid medical team. The patient was conscious, in a stable circulatory and respiratory condition and immobilized. Diagnostic procedures including a CT scan revealed the following diagnoses: the rupture of the aortic arch descending part, the right occipital condyle fracture, the fracture of the atlas vertebra, multiple rib fractures on the both sides, right-sided lung contusion with a small pneumothorax and contusion of the right adrenal gland. The consultant interventional cardiologist decided to perform a percutaneous closure of a tear in the aortic wall which was life threatening injury with impeding exsanguination. An emergency interventional team was summoned and in the Cath lab of our clinic a TEVAR graft measuring 28/28X157 cm was successfully implanted. During the procedure the patient was intubated and sedated. After the procedure, the patient was transferred to intensive care unit in clinically stable condition.

    Literature

    1. Strozzi M. Thoracic endovascular aortic repair in the University Hospital Centre Zagreb: Ten Years since the first Intervention, problems and results. Cardiol Croat. 2015;10(5-6):141–7. https://doi.org/10.15836/ccar.2015.141
    2. Kolbeck KJ, Kaufman JA. Endovascular stent grafts in urgent blunt and penetrating thoracic aortic trauma. Semin Intervent Radiol. 2011;28(1):98–106. https://doi.org/10.1055/s-0031-1273944
    3. Mitchell ME, Rushton FW, Boland AB, Byrd TC, Baldwin ZK. Emergency procedures on the descending thoracic aorta in the endovascular era. J Vasc Surg. 2011 Nov;54(5):1298–302. https://doi.org/10.1016/j.jvs.2011.05.010
    Cardiologia Croatica
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    Endovascular repair of the aorta using TEVAR after a traffic accident injury of the descending aorta

    Extended Abstract
    Issue1-2
    Published
    Pages63
    PDF via DOIhttps://doi.org/10.15836/ccar2018.63
    rupture of the descending aorta
    thoracic endovascular aortic repair
    endovascular procedure
    catheterization laboratory

    Authors

    Romana Palić*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Daniela ŠmalceljUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Irena OšlajUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Marija MatošUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Joško BulumORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Maja StrozziORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Ivica ŠafradinORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    *Correspondence email: romana.palich@gmail.com

    Full Text

    Introduction: In the beginning, Thoracic Endovascular Aortic Repair (TEVAR) procedure with the insertion of an endovascular stent-graft in the aorta was used for the repair of degenerative aneurysms of the descending aorta, but afterwards the indications for the procedure include the whole spectrum of descending aorta pathology, and traumatic rupture. (1–3)

    Case report: 28-years-old male driver of a family car, who was injured in a car crash, was brought into the surgical emergency department by first aid medical team. The patient was conscious, in a stable circulatory and respiratory condition and immobilized. Diagnostic procedures including a CT scan revealed the following diagnoses: the rupture of the aortic arch descending part, the right occipital condyle fracture, the fracture of the atlas vertebra, multiple rib fractures on the both sides, right-sided lung contusion with a small pneumothorax and contusion of the right adrenal gland. The consultant interventional cardiologist decided to perform a percutaneous closure of a tear in the aortic wall which was life threatening injury with impeding exsanguination. An emergency interventional team was summoned and in the Cath lab of our clinic a TEVAR graft measuring 28/28X157 cm was successfully implanted. During the procedure the patient was intubated and sedated. After the procedure, the patient was transferred to intensive care unit in clinically stable condition.

    Literature

    1. 1.
      Strozzi M. Thoracic endovascular aortic repair in the University Hospital Centre Zagreb: Ten Years since the first Intervention, problems and results. Cardiol Croat. 2015;10(5-6):141–7.DOI
    2. 2.
      Kolbeck KJ, Kaufman JA. Endovascular stent grafts in urgent blunt and penetrating thoracic aortic trauma. Semin Intervent Radiol. 2011;28(1):98–106.DOI
    3. 3.
      Mitchell ME, Rushton FW, Boland AB, Byrd TC, Baldwin ZK. Emergency procedures on the descending thoracic aorta in the endovascular era. J Vasc Surg. 2011 Nov;54(5):1298–302.DOI