Thoracic endovascular aortic repair for avulsion of aortic branches in a trauma patient requiring resuscitative thoracotomy: a case report.
Aorta
Endovascular procedures
Resuscitation
Thoracotomy
Trauma
Vascular injury
Journal
Surgical case reports
ISSN: 2198-7793
Titre abrégé: Surg Case Rep
Pays: Germany
ID NLM: 101662125
Informations de publication
Date de publication:
19 Apr 2022
19 Apr 2022
Historique:
received:
07
02
2022
accepted:
09
04
2022
entrez:
19
4
2022
pubmed:
20
4
2022
medline:
20
4
2022
Statut:
epublish
Résumé
Resuscitative thoracotomy is a lifesaving procedure for trauma patients that are hemodynamically unstable. Cross-clamping of the descending thoracic aorta is an essential procedure performed during resuscitative thoracotomy in patients with impending cardiac arrest. Although complications related to resuscitative thoracotomy have been reported, there is no report on avulsion of aortic branches related to cross-clamping of the descending aorta and its appropriate management. We present the case of a 42-year-old woman who sustained blunt trauma due to an accidental fall. The patient was hemodynamically unstable and required resuscitative thoracotomy with cross-clamping of the thoracic aorta. However, hemorrhage from avulsion of aortic branches related to aortic cross-clamping was identified. Initially, transcatheter arterial embolization was attempted to achieve hemostasis; however, when that proved ineffective, thoracic endovascular aortic repair was performed, which resulted in successful hemorrhage control without any sequelae. Thoracic endovascular aortic repair may be a management option for aortic branch avulsion due to cross-clamping of the descending aorta during resuscitative thoracotomy.
Sections du résumé
BACKGROUND
BACKGROUND
Resuscitative thoracotomy is a lifesaving procedure for trauma patients that are hemodynamically unstable. Cross-clamping of the descending thoracic aorta is an essential procedure performed during resuscitative thoracotomy in patients with impending cardiac arrest. Although complications related to resuscitative thoracotomy have been reported, there is no report on avulsion of aortic branches related to cross-clamping of the descending aorta and its appropriate management.
CASE PRESENTATION
METHODS
We present the case of a 42-year-old woman who sustained blunt trauma due to an accidental fall. The patient was hemodynamically unstable and required resuscitative thoracotomy with cross-clamping of the thoracic aorta. However, hemorrhage from avulsion of aortic branches related to aortic cross-clamping was identified. Initially, transcatheter arterial embolization was attempted to achieve hemostasis; however, when that proved ineffective, thoracic endovascular aortic repair was performed, which resulted in successful hemorrhage control without any sequelae.
CONCLUSIONS
CONCLUSIONS
Thoracic endovascular aortic repair may be a management option for aortic branch avulsion due to cross-clamping of the descending aorta during resuscitative thoracotomy.
Identifiants
pubmed: 35438386
doi: 10.1186/s40792-022-01427-4
pii: 10.1186/s40792-022-01427-4
pmc: PMC9018930
doi:
Types de publication
Journal Article
Langues
eng
Pagination
71Informations de copyright
© 2022. The Author(s).
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