Thoracic Endovascular Aortic Repair (TEVAR) for Grade III Traumatic Thoracic Aortic Injury

TL;DR

TEVAR is an effective minimally invasive treatment for traumatic thoracic aortic injuries, offering rapid stabilization and improved outcomes.

Contribution

This case study demonstrates the successful use of TEVAR in managing a traumatic thoracic aortic injury with pseudoaneurysm and dissection.

Findings

TEVAR provided adequate repair of a descending thoracic aortic injury in a 26-year-old trauma patient.

Follow-up CT angiography confirmed successful endovascular repair with favorable clinical outcomes.

TEVAR proved effective for both diagnostic and therapeutic emergency management of thoracic aortic trauma.

Abstract

The thoracic endovascular aortic repair (TEVAR) procedure has become a preferred option for managing traumatic lesions of the thoracic aorta due to its ability to intervene in a minimally invasive manner and reduce the risk of complications. This approach allows rapid patient stabilization by avoiding open surgery and facilitates the management of critical conditions, such as pseudoaneurysms of the descending aorta. Aortic contusion injury caused by trauma and deceleration is an important and serious cause of mortality related to trauma, since most of those who suffer it die at the site of the accident or in the first hours of hospital care. Hence, the clinical suspicion and the rapid approach during primary care when locating serious conditions, such as thoracic aortic injury, are of utmost importance for the survival of the affected patient. A 26-year-old woman who suffered a thoracic aortic injury due to automobile trauma was brought to the ED. She underwent TEVAR with endoprosthesis placement due to a diagnosis of pseudoaneurysm and dissection of the descending thoracic aorta (aortic isthmus). The endovascular repair was adequate. The follow-up was conducted with thoracic angiotomography, also known as a CT angiography of the chest, a medical imaging procedure that uses X-rays and a contrast dye to visualise the blood vessels in the chest, particularly the thoracic aorta, at the time of the procedure and 12 months postoperatively. The patient's clinical evolution was favourable, with the endovascular intervention proving to be an adequate option for both diagnostic and therapeutic emergency management.

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