Endovascular repair of innominate artery injury secondary to air rifle pellet: a case report and review of the literature.
OBJECTIVE
Decreased morbidity makes endovascular treatment preferable for certain central aortic and great vessel injuries. We present a case of penetrating innominate injury, describe considerations of a catheter-based approach, and provide follow-up of repair.


METHODS
A case report and review of the literature.


RESULTS
A 16-year-old man presented with an isolated innominate artery injury following an air rifle wound. Standard transfemoral approach was used to gain access the innominate artery. The injury was treated with an 8 x 35 mm, balloon-expandable, covered stent. Completion imaging confirmed a well-positioned stent with exclusion of the injury and normal flow in distal vessels. There were no symptoms of stent migration or stenosis 1 year following the injury.


CONCLUSIONS
Specific anatomic characteristics including its proximity to the carotid and vertebral arteries make the endovascular approach to the innominate artery unique. This case demonstrates the viability of catheter-based approaches in treating vascular injury.
Gifford
Shaun M
SM
Division of Vascular Surgery, Wilford Hall Air Force Medical Center, San Antonio, Texas, USA. gifford@uthscsa.edu
Deel
John T
JT
Dent
Daniel L
DL
Seenu Reddy
V
V
Rasmussen
Todd E
TE
D000293:Adolescent; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000293:injuries*; D005389:Firearms; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000628:therapy*