title: Thoracic endovascular aortic repair for blunt thoracic aortic injuries in complex aortic arch vessels anatomies.
abstract: The aim of this study is to report the use of thoracic endovascular aortic repair (TEVAR) in blunt thoracic aortic injuries (BTAIs) presenting with complex anatomies of the aortic arch vessels. Two patients were admitted to our hospital for the management of BTAI. Anomalies were as follow: aberrant right subclavian artery (n = 1) and right-sided aortic arch with 5 vessels anatomy variant (n = 1). TEVAR was accomplished using parallel graft with periscope configuration in the patient with the aberrant right subclavian artery. At 12-month follow-up, computed tomography angiographies confirmed the exclusion of the BTAI, the stability of the endograft, the resolution of the pseudoaneurysm, and the patency of the parallel endograft. Aortic arch vessels variants and anomalies are not rare, and should be recognized and studied precisely to plan the most appropriate operative treatment. TEVAR proved to be effective even in complex anatomies.
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy. Electronic address: gabriele.piffaretti@uninsubria.it.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.affiliation: Interventional Radiology, Department of Surgery and Department of Cardiovascular Sciences Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
authors.affiliation: Interventional Radiology, Department of Surgery and Department of Cardiovascular Sciences Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.affiliation: Cardiac Surgery, University of Leicester, Glenfield Hospital, Leicester, UK.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.affiliation: Interventional Radiology, Department of Surgery and Department of Cardiovascular Sciences Morphological Sciences, University of Insubria School of Medicine, Circolo University Hospital, Varese, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Macchi
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Castelli
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Tozzi
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Franchin
mesh_terms: D000783:Aneurysm / Q000175:diagnosis; D017541:Aneurysm, False / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D018376:Cardiovascular Abnormalities / Q000175:diagnosis; D003680:Deglutition Disorders / Q000175:diagnosis; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D013348:Subclavian Artery / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*