TEVAR for blunt thoracic aortic injury : case report

Abstract

Blunt thoracic aortic injuries (BTAIs) stand as a prominent cause of mortality in trauma scenarios due to high-energy blunt trauma, such as in motor vehicle accidents. Thoracic Endovascular Aortic Repair (TEVAR) has emerged as the preferred treatment modality for BTAIs owing to its minimally invasive approach and superior outcomes compared to open surgery. Here, we present the case of a 31-year-old woman involved in a severe motor vehicle accident, resulting in acute thoracic aortic injury managed with TEVAR in Mater Dei hospital.

Upon admission, the patient demonstrated signs of hemodynamic instability, prompting urgent CT imaging which revealed aortic injury alongside other traumatic injuries. Emergency TEVAR was successfully executed under general anesthesia, followed by revascularization for a concurrent popliteal artery injury. Subsequent imaging confirmed proper stent positioning and resolution of the aortic injury. The patient experienced a satisfactory recovery with a hospital stay lasting 25 days.

Diagnosing BTAIs poses challenges due to their nonspecific clinical manifestations, necessitating reliance on imaging modalities, primarily computed tomographic angiography (CTA). TEVAR offers distinct advantages over open surgery, including reduced invasiveness, shorter operative times, and decreased postoperative complications. However, long-term surveillance remains crucial due to potential complications. TEVAR persists as the primary treatment modality for eligible BTAIs, ensuring favorable patient outcomes and enhanced recovery.