Endovascular treatment of a blunt traumatic abdominal aortic injury with a commercially available stent graft.
Abdominal aortic injuries are rarely encountered in blunt abdominal trauma. The traditional treatment of these injuries has been surgical exploration and repair. Endografts are commonly used in the repair of abdominal aortic aneurysms. We present a case of a blunt abdominal aortic injury treated successfully with a commercially available endograft. A 26-year-old male was involved in a rollover motor vehicle collision. Evaluation revealed an aortic injury as well as a concomitant small bowel injury. No treatment of the aorta was undertaken initially; however, on 6-month follow-up, the patient developed bilateral hip and buttock claudication. Computed tomography and aortography revealed two areas of stenosis with an associated pseudoaneurysm. The patient was treated with three 22 mm AneuRx (Medtronic, Sunnyvale, CA) aortic extender cuffs. Balloon angioplasty of the stenosis was also performed. The patient's symptoms resolved, and he was well at 9 months postprocedure. We report the use of aortic extender cuffs to treat a blunt abdominal aortic injury. The potential to treat these injuries with aortic extender cuffs emergently or electively at any institution represents an advance in the management of vascular trauma.
Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA. tteruya@ahs.llumc.edu
Theodore H
TH
Teruya
Christian
C
Bianchi
Ahmed M
AM
Abou-Zamzam
Jeffrey L
JL
Ballard
D000328:Adult; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D019917:Blood Vessel Prosthesis Implantation; D004108:Dilatation, Pathologic; D006801:Humans; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery*