Endovascular Treatment of Traumatic Aortic Dissection and Innominate Artery Pseudoaneurysm

Zoffoli, Giampaolo; Saccani, S; Larini, P; Colli, Andrea; Gherli, Tiziano

doi:10.1097/01.ta.0000229991.73863.3d

Cited by 9 publications

(5 citation statements)

References 20 publications

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“…Endovascular stent-grafts have been quite successful in many clinical applications, including successful stenting of an innominate pseudoaneurysm, as in this case. 4,6,7 This case highlights the relative ''ease'' and fast repair (less than 35 minutes) for what used to be considered a major and long operation. There was no general anesthesia involved and almost no recovery time from the endovascular repair besides the right arteriotomy closure.…”

Section: Discussionmentioning

confidence: 96%

“…The innominate artery is the second most commonly injured branch of the mediastinal vessels, with the proximal segment most commonly involved. [1][2][3][4][5][6][7][8] Early diagnosis of innominate artery pseudoaneurysm is imperative because delay may allow rupture, exsanguination, embolus formation, or indolent enlargement, compromising adjacent structures like the other great arteries, superior vena cava, brachiocephalic veins, and trachea. We report successful management of a traumatic intimo-medial dissection with pseudoaneurysm formation at the origin of the innominate artery prior to onset of fatal complications.…”

Section: Introductionmentioning

confidence: 99%

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Early Diagnosis and Treatment of a Posttraumatic Pseudoaneurysm/Dissection of the Innominate Artery

Azarcon

Ghaleb

2014

Prehosp. Disaster med.

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A 25-year-old male developed a traumatic intimo-medial dissection and saccular pseudoaneurysm at the origin of the innominate artery following a motorcycle accident. On physical examination there was no perceivable trauma to the chest. In addition, there were no clinical symptoms that suggested this serious injury. The patient was managed with successful stent-graft placement on an elective basis.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Early Diagnosis and Treatment of a Posttraumatic Pseudoaneurysm/Dissection of the Innominate Artery

Azarcon

Ghaleb

2014

Prehosp. Disaster med.

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“…A MEDLINE search using the query Blunt AND (Injury OR Trauma) AND ("Innominate Artery" OR "Brachiocephalic Artery" OR "Brachiocephalic Trunk") yielded 116 entries, among which only 10 cases were related to hybrid or pure endovascular correction of a blunt traumatic injury of the IA. 2,4,5,22,[24][25][26][27][28][29] The type of lesion repair and a small description of the procedure and follow-up, when mentioned, are presented in Table 1. The main drawbacks of endovascular treatment in this case were the young age, fitness of the patient, and even more importantly, the fact that aortic arch involvement was not definitively demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report

Dias-Neto

Ramos

Teixeira

2018

Vasc Endovascular Surg

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Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation. The patient underwent emergent angiography, which confirmed that the IA dissection was not ruptured, but it was unclear whether there was a pseudoaneurysm at the origin of the IA or aortic arch involvement. The patient was considered for open surgery. An ascending aorta-to-IA bypass was achieved by the off-pump beating heart approach. The IA stump was carefully observed, but oversewing was not possible due to the extension of the intimal-medial lesions into the artic arch. An on-pump intervention was then required for aortic angioplasty with a pericardial patch that was reinforced by Gel Seal. The postoperative course was uneventful. The patient was discharged without any complications. Conventional surgery provides good results and should remain in the armamentarium for the treatment of traumatic lesions at the IA origin, particularly if aortic arch involvement cannot be ruled out, to ensure a truly patient-tailored approach.

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“…As a consequence of major car crashes, thoracic aortic ruptures occur in 10 to 30% of multiply injured patients [5]. They represent the second most common cause of death after trauma, following only the head injuries [6].…”

Section: Discussionmentioning

confidence: 99%

Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

Mitsos

Chantler

Konstantinou

et al. 2009

Cases J

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Blunt traumatic injury and acute dissection of thoracic aorta is increasing in incidence in seriously multi-trauma patients, remaining highly lethal. Early identification and repair is the key to a successful outcome. We report an unusual case of a 62-year-old man involved in a motor vehicle accident after subarachnoid hemorrhage due to an intracranial artery aneurysm rupture. The post-traumatic aorta dissection was overlooked during the initial evaluation and was found incidentally later during an attempt for endovascular treatment of the intracranial aneurysm. The pitfalls in the diagnostic approach of this patient are discussed and the paramount importance of the correct interpretation of all the available clinical and investigational findings in multiple injured patients are highlighted.

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Endovascular Treatment of Traumatic Aortic Dissection and Innominate Artery Pseudoaneurysm

Cited by 9 publications

References 20 publications

Early Diagnosis and Treatment of a Posttraumatic Pseudoaneurysm/Dissection of the Innominate Artery

Early Diagnosis and Treatment of a Posttraumatic Pseudoaneurysm/Dissection of the Innominate Artery

Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report

Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

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