PDF(Pubmed)
Abstract：
Blunt thoracic aortic injury (BTAI) is fatal and requires thoracic endovascular aortic repair (TEVAR) for its optimal management. Performing TEVAR requires multidisciplinary specialists and supportive facilities. We report a case of an 89-year-old man who presented to the emergency department with blunt trauma. Whole-body computed tomography (CT) revealed grade II aortic injury with disrupted blood flow to the left kidney. Sudden paralysis of the left lower extremity and distal progression of the aortic dissection occurred. However, TEVAR could not be performed immediately. Therefore, an external shunt from the right common femoral artery to the left lower extremity was created with angioplasty, superior mesenteric artery (SMA) stenting, and celiac artery (CA) balloon dilatation. The patient\'s condition stabilized, and he was transferred to a hospital where TEVAR was performed. Selective arterial catheterization (SAC) for treating intraperitoneal organ malperfusion caused by BTAI may be an effective bridging therapy for TEVAR.
摘要：
闭合性胸主动脉损伤（BTAI）是致命的，需要胸血管内主动脉修复（TEVAR）以进行最佳治疗。执行TEVAR需要多学科专家和支持设施。我们报告了一例89岁的男子，他因钝性外伤向急诊科就诊。全身计算机断层扫描（CT）显示II级主动脉损伤，左肾血流中断。左下肢突然瘫痪，主动脉夹层远端进展。然而,无法立即执行TEVAR。因此,通过血管成形术形成了从右股总动脉到左下肢的外部分流，肠系膜上动脉（SMA）支架置入术，和腹腔动脉（CA）球囊扩张。病人的病情稳定了,他被转移到一家进行TEVAR的医院。用于治疗由BTAI引起的腹膜内器官灌注不良的选择性动脉导管插入术（SAC）可能是TEVAR的有效桥接疗法。
