Coil Embolization of Post-Traumatic Pseudoaneurysm of the Ascending Aorta

Am J Case Rep. 2021 Jun 21:22:e931844. doi: 10.12659/AJCR.931844.

Abstract

BACKGROUND Traumatic rupture of the ascending aorta is a life-threatening injury, with a survival rate of around 15% to 20%. Treatment with open surgical repair is the criterion standard. However, open surgical repair is associated with high mortality and morbidity in patients with multiple traumas. There are no systematic data on traumatic thoracic rupture and aorta rupture in a cohort of patients who had undergone partial or total replacement of the thoracic aorta. We can only speculate about the mechanisms and consequences of such an injury. Therefore, even unorthodox endovascular techniques are a welcome advancement in this field and should be considered, providing they do not compromise patient safety. CASE REPORT A 61-year-old man presented with polytrauma after a fall from height. Since the patient had a history of a Bentall procedure, hypertension, coronary disease, and nicotinism, we quickly excluded open surgery as a treatment option. However, the patient's condition, additional injuries, and anatomical features prompted us to perform coil pseudoaneurysm, reducing his operative trauma and allowing for his faster recovery and early rehabilitation. The patient has remained under careful clinical supervision. The result of the patient's 1-year follow-up was satisfactory. CONCLUSIONS In this case, the endovascular approach was an effective, if temporary, option to open or hybrid surgery. This demonstrates that minimally invasive surgery can be helpful in some patients and can also be helpful as a bridge therapy. A good rapport between the surgeon and the patient is crucial to understanding the advantages and disadvantages of such treatment.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False* / diagnostic imaging
  • Aneurysm, False* / etiology
  • Aneurysm, False* / surgery
  • Aorta / surgery
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Blood Vessel Prosthesis Implantation*
  • Endovascular Procedures*
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome