Covered Endovascular Repair of Innominate Artery Bifurcation After Thoracic Blunt Trauma

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Pereira Neves, A (Author) FMUP; Gouveia, R (Author) Other; Dias-Neto M (Author) FMUP; Duarte Gamas, L (Author) Other; Rocha Neves, J (Author) FMUP; Teixeira, J (Author) Other

Journal

Title: Vascular and Endovascular Surgery

ISSN: 1538-5744

Publisher: SAGE

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00T-5SY

DOI: 10.1177/1538574420976478

Abstract (EN): Innominate artery (IA) injury is a rare entity with most patients dying before reaching the hospital. While open surgery remains the standard treatment, the endovascular approach is attractive as it may reduce perioperative morbidity and mortality. We report a case of IA blunt injury extending to the subclavian artery with pseudoaneurysm formation successfully treated with covered stenting of IA and its bifurcation. A 49-year-old male was admitted after suffering multiple trauma due to a high energy impact motorcycle crash. In the emergency room, the patient was hypotensive with a Glasgow coma score of 15. On physical examination, he had right peri-orbital ecchymosis, left otorrhagia and an open patella fracture. The computed tomographic angiography (CTA) revealed enlargement of the mediastinum and a 29 mm pseudoaneurysm involving the right brachiocephalic trunk and its bifurcation. Under general anesthesia, a covered balloon-expandable stent (CBES) was then placed in the IA followed by kissing stent of its bifurcation with an additional 2 covered balloon-expandable stents. Final subtraction angiography demonstrated complete pseudoaneurysm exclusion and stent patency without additional complications. No neurologic deficits or other intervention-related complications were found in the postoperative period. At 10 months follow-up, the patient remained asymptomatic and with palpable distal pulses. Endovascular management of IA injury may provide a good alternative to open surgery with low perioperative morbidity and mortality.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5