Fenestrated stent-graft for traumatic juxtahepatic inferior vena cava injury.
OBJECTIVE
To report the use of a fenestrated stent-graft to manage a traumatic rupture of the juxtahepatic inferior vena cava (IVC).


METHODS
A 62-year-old man was involved in a traffic accident and hospitalized for severe right leg fractures. Computed tomography also uncovered liver contusion and retroperitoneal hematoma. The next day, he became hemodynamically unstable; a huge retroperitoneal hematoma had developed from a rupture of the juxtahepatic IVC. An emergent procedure to implant a self-expanding fenestrated stent-graft was successful in repairing the IVC injury and maintaining hepatic venous return. The patient recovered and continues in good health with a patent endograft 16 months after treatment.


CONCLUSIONS
This experience supports the efficacy of fenestrated endograft implantation for emergent repair of IVC injuries, although proper facilities, an experienced interventional team, and an assortment of devices must be available.
Watarida
Shoji
S
Second Department of Surgery, Shiga University of Medical Science, Japan. SW2728@aol.com
Nishi
Takao
T
Furukawa
Akira
A
Shiraishi
Shoichiro
S
Kitano
Haruhisa
H
Matsubayashi
Keiji
K
Imura
Masato
M
Yamazaki
Michio
M
D000063:Accidents, Traffic; D000792:Angiography / Q000379:methods; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods*; D005500:Follow-Up Studies; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000628:therapy*; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000293:injuries; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000628:therapy; D012421:Rupture / Q000000981:diagnostic imaging / Q000628:therapy; D012720:Severity of Illness Index; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries*