Abstract
We report the case of a patient who suffered major trauma following a motorcycle accident that resulted in multiple fractures, bilatéral hemopneumothorax, pulmonary contusions, and an isthmic rupture of the aorta with a pseudoaneurysm compressing the descending aorta. This compression was responsible for distal hypotension and low flow, leading to acute rénal insufficiency and massive rhabdomyolysis. Due to the critical clinical status of the patient, which prevented any type of open thoracic surgery, endovascular treatment was performed. An initial stent-graft permitted alleviation of the compression and the re-establishment of normal hemodynamic conditions, but its low position did not allow sufficient coverage of the rupture. A second stent-graft permitted total exclusion of the pseudoaneurysm while preserving the patency of the left subclavian artery.
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References
Cornwell EE, Kennedy F, Berne TV, Asensio JA, Demetriades D (1995) Gunshot wounds to the thoracic aorta in the 90s: Only prevention will make a difference. Ara Surg 61:721–723
Soyer R, Bessou JP, Bouchart F, Tabley A, Mouton-Schleifer D, Arrignon J, Redonnet M (1992) Acute traumatic isthmic aortic rupture: Long-term results in 49 patients. Eur J Cardiothorac Surg 6:431–436
Ruberti U, Arpesani A, Giorgetti PL, Cugnasca M, Rampoldi V, Selva S (1990) Traumatic pathology of the thoracic aorta: Personal experience based on 42 cases. Panminerva Med 32:28–31
Glock Y, Roux D, Soula P, Cerene A, Fournial G (1996) Traumatic rupture of the thoracic aorta. Rev Esp Cardiol 49 [Suppl 4]: 100–106
Parodi JC, Palmaz JC, Barone HD (1991) Trans-femoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vase Surg 5:491–499
Dake MD, Miller DC, Semba CP, Mitchell RS, Lidell RP (1994) Transluminal placement of endovascular stent grafts for the treatment of descending thoracic aortic aneurysm. N Engl J Med 331:1729–1734
Kato N, Dake M, Miller C, Semba C, Mitchell S, Razavi M, Kee S (1997) Traumatic thoracic aortic aneurysm: Treatment with endovascular stent-grafts. Radiology 205:657–662
Semba C, Kato N, Kee S, Lee G, Mitchell S, Miller C, Dake M (1997) Acute rupture of descending thoracic aorta: Repair with use of endovascular stent-grafts. J Vase Interv Radiol 8:337–342
Donayre CE, Scoccianti M (1995) Applications in peripheral vascular surgery: Traumatic arteriovenous fistulas and pseudoaneurysms. In: Chuter TAM, Donayre CE, White RA (eds) Endovascular Prosthesis. Little, Brown, Boston, pp 217–236
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Bruninx, G., Wery, D., Dubois, E. et al. Emergency endovascular treatment of an acute traumatic rupture of the thoracic aorta complicated by a distal low-flow syndrome. Cardiovasc Intervent Radiol 22, 515–518 (1999). https://doi.org/10.1007/s002709900442
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DOI: https://doi.org/10.1007/s002709900442