Emergency endovascular treatment of an acute traumatic rupture of the thoracic aorta complicated by a distal low-flow syndrome

We report the case of a patient who suffered major trauma following a motorcycle accident that resulted in multiple fractures, bilateral hemopneumothorax, pulmonary contusions, and an isthmic rupture of the aorta with a pseudoaneurysm compressing the descending aorta. This compression was responsibl...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 1999-11, Vol.22 (6), p.515-518
Main Authors: BRUNINX, G, WERY, D, DUBOIS, E, EL NAKADI, B, VAN DUEREN, E, VERHELST, G, DELCOUR, C
Format: Article
Language:English
Subjects:
ACCIDENTS
Adult
Aneurysms
AORTA
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - physiopathology
Aortic Aneurysm, Thoracic - therapy
Aortic Rupture - diagnostic imaging
Aortic Rupture - physiopathology
Aortic Rupture - therapy
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular disease
Cardiovascular system
Compressing
Compression
Diseases of the aorta
Emergency medical services
Emergency Treatment
FRACTURES
GRAFTS
Health services
Hemodynamics
Humans
HYPOTENSION
Implants
INJURIES
KIDNEYS
Low flow
Male
Medical sciences
Motorcycles
PATIENTS
Pseudoaneurysm
RADIOLOGY AND NUCLEAR MEDICINE
Rhabdomyolysis
Rupture
RUPTURES
Stents
SURGERY
Thoracic surgery
Thorax
Tomography, X-Ray Computed
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Description
Summary:We report the case of a patient who suffered major trauma following a motorcycle accident that resulted in multiple fractures, bilateral hemopneumothorax, pulmonary contusions, and an isthmic rupture of the aorta with a pseudoaneurysm compressing the descending aorta. This compression was responsible for distal hypotension and low flow, leading to acute renal insufficiency and massive rhabdomyolysis. Due to the critical clinical status of the patient, which prevented any type of open thoracic surgery, endovascular treatment was performed. An initial stent-graft permitted alleviation of the compression and the re-establishment of normal hemodynamic conditions, but its low position did not allow sufficient coverage of the rupture. A second stent-graft permitted total exclusion of the pseudoaneurysm while preserving the patency of the left subclavian artery.
ISSN:0174-1551
1432-086X
DOI:10.1007/s002709900442