Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma

Hideaki Nagashima; Takuya Sugiyama; Natsuki Kondo; Masaya Miyahara; Seiichi Yamaguchi; Yosuke Matsumura

doi:10.1016/j.tcr.2021.100571

Successful application of angioembolization and thoracic endovascular aortic repair (TEVAR) in a retrograde type-A acute aortic dissection with polytrauma

Trauma Case Rep. 2021 Dec 9:37:100571. doi: 10.1016/j.tcr.2021.100571. eCollection 2022 Feb.

Authors

Hideaki Nagashima¹, Takuya Sugiyama², Natsuki Kondo¹, Masaya Miyahara¹, Seiichi Yamaguchi³, Yosuke Matsumura¹

Affiliations

¹ Department of Intensive Care, Chiba Emergency Medical Center, Chiba city, Chiba, Japan.
² Department of Anesthesiology, Chiba Emergency Medical Center, Chiba city, Chiba, Japan.
³ Department of Cardiovascular Surgery, Chiba Emergency Medical Center, Chiba city, Chiba, Japan.

Abstract

A 53-year-old man underwent thoracic endovascular aortic repair for persistent false lumen perfusion and limb salvage because of type A aortic dissection, severe lower-limb ischemia, and bleeding (mediastinal hematoma, bilateral lung contusion, liver injury, and splenic injury) caused by blunt trauma. We embolized the left supreme intercostal artery to control active mediastinal hemorrhage. Acute hemorrhage and leg ischemia were well controlled; however, residual blood flow in the false lumen persisted. We performed a Zone 2 thoracic endovascular aortic repair and discharged the patient on day 67. Thoracic endovascular aortic repair is a practical option for treating traumatic type A dissection.

Keywords: Aortic injury; Polytrauma; Stent-graft; TEVAR; Type-A aortic dissection.

Publication types

Case Reports