<- Home <- Arhive <- Vol. 26, Issue 3, September 2018



Rom J Leg Med26(3)235-240(2018)
DOI:10.4323/rjlm.2018.235
© Romanian Society of Legal Medicine


Post traumatic rupture of the isthmic aorta in multitrauma patients involved in car accidents: Our initial experience with emergency endovascular repair

O. Stiru, R. Vasile , R. C. Geana , D. I. Sorostinean , P. Pavel , M. Croitoru, L. Predescu , L. Valeanu , S. Bubenek , V. A. Iliescu


Abstract: Emergency endovascular treatment of traumatic aortic rupture of the isthmus (TARI) after crush accidents is an alternative to open repair (OR). Two patients, both victims of car accidents with multiple trauma and TARI were presented after 48 hours, respectively 10 hours after accident to our institution. Diagnosis was based on computed tomography angiography (CTA) on both cases, initial management and stabilization of the patients were performed in other hospitals and included resuscitation protocols, blood pressure control, as well as treatment of other associated injuries. Both patients had stable rupture of the aortic isthmus with tear associated with aortic isthmic hematoma and left hemothorax. Initial conservative treatment allowed management of the major associated lesions, and after analysing the CTA images the patients were considered suitable for emergency thoracic endovascular aortic repair (TEVAR) and transferred to our hospital. In emergency, both patients had a Valiant Thoracic endograft with the Captivia Delivery System (Medtronic Vascular, Santa Rosa, California) implanted. The postoperative evolution was clinically uneventful, and the patients were discharged from the hospital on the 9th day, respectively 12th day after TEVAR procedure. The purpose of the present study is to report our first two successful cases of emergency TEVAR in patients with multiple trauma and TARI after car accidents and to discuss some important issues related to this approach.
Keywords: Traumatic aortic rupture of the isthmus, thoracic endovascular aortic repair.



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