Thoracic Endovascular Aortic Repair in an Adolescent Patient with Thoracic Aortic Dissection due to Blunt Trauma: A Case Report


Huseynzade S., Akdoğan B., Doğru M., Skaık M. N., Tansel T.

24th Congress of Asian Society for Vascular Surgery, Antalya, Turkey, 30 November - 03 December 2023, pp.384

  • Publication Type: Conference Paper / Summary Text
  • City: Antalya
  • Country: Turkey
  • Page Numbers: pp.384
  • Istanbul University Affiliated: Yes

Abstract

BACKGROUND: Thoracic aortic dissection (TAD) is a condition with a high mortality rate due to rupture of the intima layer of the aorta, which disrupts the normal circulatory pathway of blood and requires urgent medical intervention. Hypertension, aortic aneurysm, bicuspid aortic valve, collagen tissue diseases (eg. Marfan Syndrome) are the main causes. TAD most commonly occurs in the fifth to seventh decade of life and is rare in children and young adults. Literature studies show that congenital cardiovascular diseases are the most common predisposing factor in pediatric patients. Trauma-associated aortic dissection is considered to be a rare condition. In this report, we describe the application of Thoracic Endovascular Aortic Repair (TEVAR) in an adolescent patient with TAD due to blunt trauma.

METHODS: A 16-year-old male patient was admitted to our clinic with a non-vehicle traffic accident. On physical examination, distal pulses were palpated. Subsequently, thoraco-abdominal CT Angio imaging revealed TAD and he was operated under emergency conditions for TEVAR.

RESULTS: CT Angio imaging showed an area compatible with a dissection flap with pseudoaneurysmatic dilatation accompanied by pseudoaneurysmatic dilatation with mural thrombus images in a segment approximately 3.5 cm long after the ascending left subclavian artery of the aorta. The decision was made to perform TEVAR. Access was obtained through the right common femoral artery and an endovascular stent was placed from the level of the aortic arch to the midregion of the descending aorta. After postoperative intensive care unit and ward follow-up, the patient was discharged with complete recovery.

CONCLUSIONS: TAD caused by blunt trauma is rare in pediatric patients. In cases secondary to trauma, urgent evaluation by CT-Angio scanning of the case and planning the most appropriate treatment is important. The use of endovascular treatment methods, especially in the adolescent age group, is still a matter of debate due to lack of adequate usage.