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Immediate endovascular stent graft repair of acute thoracic aortic rupture caused by blunt trauma
  1. G P Georghiou,
  2. B A Vidne,
  3. E Sharoni

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We present a case of trauma induced thoracic aortic rupture treated by immediate graft stenting. A 22 year old male victim of a head-on collision between his motorcycle and a car presented to the trauma unit. Chest x ray showed widening of the mediastinum, and the patient was referred for total body computed tomography. Findings revealed a traumatic aortic tear (panel A, arrow), and injuries to the head, kidney, and pelvis. Further evaluation by aortic injection in the invasive radiology unit confirmed the diagnosis of traumatic aortic tear with pseudoaneurysm formation (panel B, arrow).

Treatment consisted of a 24 mm covered stent graft, introduced through the femoral artery and placed at the tear site (panel C).

Repeated aortic injection after the procedure demonstrated no leakage of contrast material outside the aorta. The patient remained haemodynamically stable and slowly recovered from his additional injuries.

On follow up transoesophageal echocardiography, the stent appeared in place with no enlargement or leakage of the pseudoaneurysm.

We feel that this technique should be considered as an alternative to open surgery in selected cases.

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