title: Blunt Thoracic Aortic Injury in Case of a 15-Year-Old Boy: Difficulties and Possibilities of the Endovascular Approach.
abstract: BACKGROUND
  Blunt thoracic aortic injuries (BTAIs) are rare but life threatening. Most BTAI are caused by high-energy trauma. Among children with blunt trauma, the incidence of BTAI is below 1 percent. The present case deals with covered thoracic aortic rupture of a 15-year-old boy. Emphasizing the value and the difficulties of endovascular surgery in children is the motivation for this case report.
  
  
  METHODS
  We are presenting the case of a 15-year-old boy, who suffered multiple traumata after accident. Beneath multiple fractures and a liver laceration, a thoracic aortic rupture with pseudoaneurysm of the aortic wall was diagnosed. Owing to the comorbidities, an endovascular therapy in combination with a transposition of the left subclavian artery to the common carotid artery was performed. The chronological line-up of the events and the endovascular treatment as well as the in-hospital follow-up are described.
  
  
  CONCLUSIONS
  Injury-induced BTAI in pubescent children rarely occurs. Only few cases can be found in literature, none of which were associated with the presented pattern of injury.
  
  
  CONCLUSIONS
  The optimal treatment for childhood BTAI is a case-by-case decision. We critically discuss the value of endovascular therapy in the present case.
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany. Electronic address: agombert@ukaachen.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gombert
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Barbati
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany; Institute for Cardiovascular Prevention, Ludwig-Maximilians University Munich, München, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Grommes
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Houman
authors.initials: H
authors.lastname: Jalaie
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Karina
authors.initials: K
authors.lastname: Schleimer
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany; European Vascular Center Aachen-Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.affiliation: Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kalder
mesh_terms: D000293:Adolescent; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D017536:Carotid Artery, Common / Q000601:surgery; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D015607:Stents; D013348:Subclavian Artery / Q000601:surgery; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*