Physician-modified endograft in ruptured aortic arch

Tomasz Jędrzejczak; Michał Żołnierczuk; Maciej Molski; Paweł Rynio; Anita Rybicka; Arkadiusz Kazimierczak

doi:10.5114/aic.2022.115562

Physician-modified endograft in ruptured aortic arch

Postepy Kardiol Interwencyjnej. 2022 Mar;18(1):70-73. doi: 10.5114/aic.2022.115562. Epub 2022 Apr 20.

Authors

Tomasz Jędrzejczak¹, Michał Żołnierczuk², Maciej Molski², Paweł Rynio², Anita Rybicka³, Arkadiusz Kazimierczak²

Affiliations

¹ Cardiac Surgery Department, Pomeranian Medical University, Szczecin, Poland.
² Vascular Surgery Department, Pomeranian Medical University, Szczecin, Poland.
³ Department of Nursing, Pomeranian Medical University, Szczecin, Poland.

Abstract

We present the case of a 27-year-old motorcyclist after a multi-organ trauma. He suffered a rupture of the aortic arch located in zone 2 and was disqualified from surgical replacement of the aortic arch due to active bleeding from parenchymal organs. Instead, he was provided with a physician-modified endograft (PMEG) to complete fenestrated thoracic endovascular aortic repair as a damage control procedure. No reports in the world literature are found regarding the use of PMEG technology in truly ruptured post-traumatic pseudo-aneurysm on the border of zone 1 and 2 of the aortic arch in emergency settings. The surgery provided temporary supply of the aorta and allowed all of the other surgical and orthopedic procedures to be completed. Endovascular treatment of aortic arch damage with PMEG is possible and can be effectively used for urgent indications when an open operation is not possible.

Keywords: fenestrated thoracic endovascular aortic repair; physician-modified endograft; ruptured aortic arch.