Seat belt aorta: endovascular management with a stent-graft.
OBJECTIVE
To report the endovascular treatment of a relatively uncommon type of deceleration injury to the abdominal aorta.


METHODS
A 21-year-old backseat passenger was wearing a single lap belt without shoulder harness when the car was involved in a collision. He sustained a transverse (Chance) fracture of the third lumbar vertebra and a circumferential dissection of the infrarenal abdominal aorta with pseudoaneurysm. As an interim measure while a stent-graft was obtained, a Wallstent was deployed to tack down the dissection and prevent distal embolization. Thirty-six hours later, an AneuRx endograft was successfully implanted inside the Wallstent to seal the pseudoaneurysm. The patient's recovery was uneventful, and the endograft remains secure and the pseudoaneurysm excluded at 10 months after the accident.


CONCLUSIONS
Endovascular repair of "seat belt aorta" is a minimally invasive, straightforward method of management for this type of aortic injury. The potential for infection in a contaminated peritoneal cavity and the long-term outcome of this treatment have not been determined.
Fontaine
A B
AB
Department of Radiology, University of Washington Medical Center, Seattle 98195-7115, USA. afontain@u.washington.edu
Nicholls
S C
SC
Borsa
J J
JJ
Hoffer
E
E
Bloch
R D
RD
Kohler
T
T
D000328:Adult; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery / Q000628:therapy; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000293:injuries*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D006801:Humans; D008297:Male; D012622:Seat Belts / Q000009:adverse effects*; D015607:Stents; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*