Aortic deceleration injury treated by endograft: a case report with 11-year followup

Abstract

Aortic deceleration injury is a common and critical condition following automobile accident with high fatality. The survivors complicated with associated serious injuries are even rare and definitive treatment is required. A 37-year-old male patient had both aortic blunt injury and coronary artery injury after a frontal car collision. After failed coronary artery percutaneous transluminal angioplasty (PTA) and deteriorated aortic lesion, the ruptured aorta was subsequently successfully treated by us with a self-made individualized endograft. The endograft was well in position and the patient functioned well in 11-year followup. With the development of endograft and technique, the endovascular treatment may be an option for patients with complicated aortic blunt injury. Yet careful patient selection and the long-term followup are essential.

Figure 1

(a) MRI showing a spindle-shaped aneurysm at the beginning of the descending aorta with a suspected rupture in its inner wall (arrow); (b) DSA showing a fusiform aneurysm at the top of the descending aorta; (c) the lesion is properly treated by an endograft; (d) follow-up MRI showing a well-deployed endograft two years after deployment.

Figure 2

The CTA 10 years after endovascular treatment: the endograft remained in the original position with slight dilation at its center (arrow).