Debranched Thoracic Endovascular Aortic Aneurysm Repair in a Case of Blunt Aortic Injury
10.4326/jjcvs.40.159
- VernacularTitle:若年鈍的外傷性大動脈損傷に対する頸部分枝バイパス併用下ステントグラフト内挿術の1例
- Author:
Kazuki Hisatomi
;
Koji Hashizume
;
Tsuneo Ariyoshi
;
Shinichiro Taniguchi
;
Seiji Matsukuma
;
Ichiro Matsumaru
;
Daisuke Onohara
;
Mizuki Sumi
;
Kiyoyuki Eishi
- Publication Type:Journal Article
- Keywords:
blunt aortic injury;
thoracic endovascular aortic aneurysm repair;
debranched;
brain injury;
multiple traumas
- From:Japanese Journal of Cardiovascular Surgery
2011;40(4):159-163
- CountryJapan
- Language:Japanese
-
Abstract:
A 16-year-old boy had a motorcycle accident and was given a diagnosis of blunt aortic injury (BAI) by contrast computed tomography (CT), complicated by diffuse brain injury, lung contusions and blunt liver injury. Despite conservative treatment his anemia worsened and further CT images revealed mediastinal hematoma. It was difficult to perform cardiopulmonary bypass with systemic heparinization because of his multiple injuries and therefore decided to perform endovascular stentgrafting. Aortography revealed that the proximal stent-graft landing zone to be very small, and therefore it was necessary to the cover left common carotid artery. Before stentgrafting, we performed a right subclavian artery-left common carotid artery bypass to attain a sufficient proximal landing zone, and stentgrafting was successful. We concluded that endovascular stentgrafting is an effective initial treatment for BAI complicated with multiple injuries. However, endovascular stentgrafting for BAI has some limitations because of the morphologic and anatomical characteristics of the thoracic aorta in cases of BAI. It is therefore important to perform endovascular stentgrafting for BAI on a case-by-case basis.
