[Endovascular Repair of Traumatic Injury to the Descending Aorta and the Right Subclavian Artery;Report of a Case].

ABSTRACT

A 32-year-old man leaping down from the 3rd floor of his house got injured and was transferred to our center. Pseudoaneurysm at the aortic isthmus as well as pelvic and lower limb fractures were observed by computed tomography (CT) scan. Thoracic endovascular aortic repair(TEVAR)of the thoracic aorta was performed from zone 2, followed by external skeletal fixation. Postoperative chest X-ray revealed right hemothorax, and CT scan showed active bleeding from the right subclavian artery in addition to splenic artery pseudoaneurysm. A 10×60 mm covered stent was deployed at the right subclavian artery and coiling of the splenic artery was performed. He was discharged without complication. The timing and procedures of surgery are difficult to decide in treatment of aortic injury with multiple trauma, TEVAR makes quick control of bleeding possible by less invasive approach. Moreover, endovascular approach to the subclavian artery avoides median sternotomy.