THORACIC AORTIC ANEURISM 29 YEARS AFTER LACERATION AND PRIMARY REPAIR

Authors

  • Margarida S. Ferreira Hospital Garcia de Orta; Faculdade de Medicina da Universidade de Lisboa, Portugal
  • Gil Marques Hospital Garcia de Orta, Portugal
  • António Gonzalez Hospital Garcia de Orta, Portugal
  • Gonçalo Sousa Hospital Garcia de Orta, Portugal
  • João Vieira Hospital Garcia de Orta, Portugal
  • Maria José Ferreira Hospital Garcia de Orta, Faculdade de Medicina da Universidade de Lisboa, Portugal

DOI:

https://doi.org/10.48750/acv.218

Keywords:

Aortic laceration, Traumatic aneurysm, TEVAR

Abstract

Blunt thoracic aortic injury is a highly lethal injury both in the prehospital and in hospital setting.
Survival of this injury is rare and therefore there is few data on the long term prognosis of these patients.
We report a case of a patient who underwent primary repair of a traumatic thoracic aorta laceration and presented 29 years later with an aortic aneurysm in the same location as the initial repair. The patient was submitted to endovascular repair of the aneurysm. The techniques for repair of traumatic aortic lacerations and the available evidence on the prognosis of these patients are reviewed, with a focus on the incidence of secondary injuries after initial repair and proposed follow-up plans.

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References

1. Fabian TC, Richardson JD, Croce MA, Smith JS Jr, Rodman G Jr, Kearney PA et al. Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma. J Trauma. 1997;42(3):374–80.
2. Katsumata T, Shinfeld A, Westaby S. Operation for chronic traumatic aortic aneurysm: when and how?. Ann Thorac Surg. 1998;66(3):774–78.
3. Demers P, Miller C, Scott Mitchell R, Kee ST, Lynn Chagonjian RN, Dake MD. Chronic traumatic aneurysms of the descending thoracic aorta: mid-term results of endovascular repair using first and second-generation stent-grafts. Eur J Cardiothorac Surg. 2004;25(3):394-400.
4. Parmley LF, Mattingly TW, Manion WC, Jahnke EJ Jr. Nonpenetrating traumatic injury of the aorta. Circulation.1958;17(6):1086–101.
5. Clancy TV, Gary Maxwell J, Covington DL, Brinker CC, Blackman D. A statewide analysis of level I and II trauma centers for patients with major injuries. J Trauma. 2001;51(2):346-51
6. Richens D, Field M, Neale M, Oakley C. The mechanism of injury in blunt traumatic rupture of the aorta. Eur J Cardiothorac Surg. 2002;21(2):288-93
7. Brinkman WT, Szeto WY, Bavaria JE. Overview of great vessel trauma. Thorac Surg Clin. 2007;17(1):95-108.
8. Nzewi O, Slight RD, Zamvar V. Management of blunt thoracic aortic injury. Eur J Vasc Endovasc Surg. 2006;31(1):18-27.
9. Taşoğlu I, Sert DE, Lafçı G, Genç B, Kavasoğlu K, Ulus AT et al. Thoracic aorticaneurysmsafterblunttrauma.UlusTravmaAcilCerrahiDerg. 2013;19(4):343-7
10. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(41):2873-926
11. Lee WA, Matsumura JS, Mitchell RS, Farber MA, Greenberg RK, Aziz- zadeh A et al. Endovascular repair of traumatic thoracic aortic injury: clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg. 2011;53(1):187-92.
12. Riambau V, Böckler D, Brunkwall J, Cao P, Chiesa R, Coppi G et al. Editor's Choice – Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017 Jan;53(1):4-52
13. Passaro E Jr, Pace WG. Traumatic rupture of the aorta. Surgery. 1959;46:787-91.
14. Razzouk AJ, Gundry SR, Wang N, del Rio MJ, Varnell D, Bailey LL. Repair of traumatic aortic rupture: a 25-year experience. Arch Surg. 2000;135(8):913-8.
15. McBride LR, Tidik S, Stothert JC, Barner HB, Kaiser GC, Willman VL et al. Primary Repair of Traumatic Aortic Disruption. Ann Thorac Surg. 1987;43(1):65-67.
16. Xenos ES, Abedi NN, Davenport DL, Minion DJ, Hamdallah O, Sorial EE et al. Meta-analyses of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg. 2008;48(5):1343- 51.
17. Tang GL, Tehrani HY, Usman A, Katariya K, Otero C, Perez E, et al. Reduced mortality, paraplegia, and stroke with stent graft repair of blunt aortic transections: a modern meta-analysis. J Vasc Surg. 2008;47(3):671-5.
18. Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma. 2008;64:561-70.
19. Hoffer EK, Forauer AR, Silas AM, Gemery JM. Endovascular sten- t-graft or open surgical repair for blunt thoracic aortic trauma: systematic review. J Vasc Interv Radiol. 2008;19:1153-64.
20. Soyer R, Bessou JP, Bouchart F, Tabley A, Mouton-Schleifer D, Arrignon J, et al. Acute traumatic isthmic aortic rupture. Long-term results in 49 patients. Eur J Cardiothorac Surg. 1992;6(8):431-6.
21. Marcu CB, Nijveldt R, Van Rossum AC. Unsuspected chronic trau- matic aortic pseudoaneurysm – what to do about it. Late post-trau- matic aortic pseudoaneurysm. Can J Cardiol 2008;24(2):143-144.
22. Miller S, Kumar P, Van den Bosch R, Khanafer A. Chronic Thoracic Aortic Aneurysm Presenting 29 Years following Trauma. Case Rep Surg. 2015: 470917.
23. Prater SP, Leya FS, McKiernan TL. Post-traumatic pseudoaneurysm of the ascending aorta — an incidental finding two decades later. Clin. Cardiol. 1994;17(10):566-568.
24. Roques X, Remes J, Laborde MN, Guibaud JP, Rosato F, MacBride T, et al. Surgery of chronic traumatic aneurysm of the aortic isthmus: benefit of direct suture. Eur J Cardiothorac Surg. 2003;23(1):46-9.
25. Naughton PA, Park MS, Morasch MD, Rodriguez HE, Garcia-Toca M, Wang CE, et al. Emergent Repair of Acute Thoracic Aortic Catastro- phes: A Comparative Analysis. Arch Surg. 2012;147(3):243–249.
26. Karmy-Jones R, Jackson N, Long W, Simeone A. Current Management ofTraumaticRuptureoftheDescendingThoracicAorta.CurrCardiol Rev. 2009;5(3):187-95.
27. Makaloski V, Spanos K, Schmidli J, Kölbel T. Surveillance After Endovascular Treatment for Blunt Thoracic Aortic Injury. Eur J Vasc Endovasc Surg. 2018 Mar;55(3):303-304.

Published

2019-12-27

How to Cite

1.
Ferreira MS, Marques G, Gonzalez A, Sousa G, Vieira J, Ferreira MJ. THORACIC AORTIC ANEURISM 29 YEARS AFTER LACERATION AND PRIMARY REPAIR. Angiol Cir Vasc [Internet]. 2019 Dec. 27 [cited 2024 Nov. 24];15(3):210-4. Available from: https://acvjournal.com/index.php/acv/article/view/218

Issue

Section

Clinical Case