Percutaneous Intervention With Balloon-Expandable Covered Stent for the Treatment of Traumatic Aortic Pseudoaneurysm in a Paediatric Patient

Abstract

In this report, we describe the case of a 13-year-old male who presented to our hospital after sustaining injuries from a motor vehicle accident (MVA). A full-body CT scan revealed multiple injuries, including subgaleal hematoma, hemorrhagic brain contusion, moderate-size aortic pseudoaneurysm with associated mediastinal hematoma, and multiple stable visceral organ lacerations. Additionally, there were numerous fractures, including in the right femur associated with large hematoma. The patient was deemed at high risk for systemic anticoagulation required for an urgent operative aortic repair. Available percutaneous endograft sizes were deemed too large for his descending aortic diameter, and the associated potential risk of vessel injury from the large sheath required to implant the endograft removed this option from consideration. The decision was made to use a balloon-expandable covered stent, which is routinely used to treat coarctation of the aorta (CoA) as a life-saving alternative. A BeGraft aortic stent (Bentley InnoMed, Hechingen, Germany) measuring 16x38 mm was successfully implanted percutaneously with complete exclusion of the pseudoaneurysm without any procedural complications.

Keywords: aortic diseases; aortic pseudoaneurysm; aortic stenting; aortic surgery; aortic trauma; endograft; injury; motor vehicle accident.