1887
Volume 2025, Issue 3
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Blunt thoracic aorta injury (BTAI) is often associated with multiple systemic injuries, which increase the risk of mortality. While thoracic endovascular aortic repair (TEVAR) is the intervention of choice in such cases, systemic stabilization is just as important for patient survival and reduction of post-operative complications. Thus, a delayed TEVAR may be a viable option in cases of hemodynamic instability and multisystemic injuries with BTAI.

We present the case of a young individual with a history of a fall with polytrauma with BTAI with multiple episodes of cardiopulmonary arrest, acute kidney injury, and sepsis who successfully underwent delayed TEVAR.

This report suggests focusing holistically on systemic components along with BTAI in cases of polytrauma, especially with hemodynamic instability. TEVAR may be delayed in such patients after a risk-benefit assessment.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2025.45
2025-09-18
2025-12-05

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2025/3/jemtac.2025.45.html?itemId=/content/journals/10.5339/jemtac.2025.45&mimeType=html&fmt=ahah

References

  1. [Google Scholar]
  2. Azizzadeh A, Keyhani K, Miller CC, Coogan SM, Safi HJ, Estrera AL. Blunt traumatic aortic injury: initial experience with endovascular repair. J Vasc Surg. 2009 Jun; 49:(6):1403–8.https://doi.org/10.1016/j.jvs.2009.02.234
    [Google Scholar]
  3. Kikuoka Y, Fujimura N, Michiura Y, Kamagata T, Tsuchiya Y, Irino S, et al. Thoracic endovascular aortic repair for cardiopulmonary arrest due to aortic dissection. Case Rep Clin Med. 2021 Oct 29; 10:(11):387–92.https://doi.org/10.4236/crcm.2021.1011048
    [Google Scholar]
  4. Gouveia e Melo R, Machado C, Caldeira D, Alves M, Lopes A, Serrano M, et al. Incidence of acute aortic dissections in patients with out of hospital cardiac arrest: a systematic review and meta-analysis of observational studies. Int J Cardiol Heart Vasc. 2021 Dec 23; 38:100934.https://doi.org/10.1016/j.ijcha.2021.100934
    [Google Scholar]
  5. Bennett DE, Cherry JK. The natural history of traumatic aneurysms of the aorta. Surgery. 1967 Apr 1; 61:(4):516–23.
    [Google Scholar]
  6. Nagy K, Fabian T, Rodman G, Fulda G, Rodriguez A, Mirvis S. Guidelines for the diagnosis and management of blunt aortic injury: an EAST Practice Management Guidelines Work Group. J Trauma. 2000 Jun; 48:(6):1128–43. https://doi.org/10.1097/00005373-200006000-00021
    [Google Scholar]
  7. Lang JL, Minei JP, Modrall JG, Clagett GP, Valentine RJ. The limitations of thoracic endovascular aortic repair in altering the natural history of blunt aortic injury. J Vasc Surg. 2010 Aug; 52:(2):290–7; discussion 297.https://doi.org/10.1016/j.jvs.2010.03.013
    [Google Scholar]
  8. Meron G, Kürkciyan I, Sterz F, Tobler K, Losert H, Sedivy R, et al. Non-traumatic aortic dissection or rupture as cause of cardiac arrest: presentation and outcome. Resuscitation. 2004 Feb; 60:(2):143–50.https://doi.org/10.1016/j.resuscitation.2003.10.005
    [Google Scholar]
  9. Moar JJ. Traumatic rupture of the thoracic aorta. An autopsy and histopathological study. S Afr Med J. 1985 Mar; 67:(10):383–5.
    [Google Scholar]
  10. Sugawara Y, Kurihara T, Ohtsubo S, Takamatsu M, Sasao K, Takebe M, et al. Recovery from out-of-hospital cardiopulmonary arrest due to type A acute aortic dissection: a case report. Case Rep Clin Med. 2016 Nov 3; 5:(11):505–10.https://doi.org/10.4236/crcm.2016.511064
    [Google Scholar]
  11. Wu Q, Sun S, Xie J, Li T, Li H, Bai X, et al. Early clinical diagnosis and treatment of traumatic aortic injury caused by thoracic and abdominal injuries: a series of four cases with literature review. BioMed Res Int. 2021 Apr 30; 2021:e9995749. https://doi.org/10.1155/2021/9995749
    [Google Scholar]
  12. Lee WA, Matsumura JS, Mitchell RS, Farber MA, Greenberg RK, Azizzadeh A, et al. Endovascular repair of traumatic thoracic aortic injury: clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg. 2011 Jan 1; 53:(1):187–92.https://doi.org/10.1016/j.jvs.2010.08.027
    [Google Scholar]
  13. Okada Y, Tanabe R, Mukaida M. Posttraumatic acute cholecystitis. Relationship to the initial trauma. Am J Forensic Med Pathol. 1987 Jun; 8:(2):164–8.
    [Google Scholar]
  14. Hamp T, Fridrich P, Mauritz W, Hamid L, Pelinka LE. Cholecystitis after trauma. J Trauma. 2009 Feb; 66:(2):400–6.https://doi.org/10.1097/TA.0b013e31815edea1
    [Google Scholar]
/content/journals/10.5339/jemtac.2025.45
Loading
/content/journals/10.5339/jemtac.2025.45
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error