Abstract：
OBJECTIVE: Blunt thoracic aortic injuries (BTAIs) involving the aortic arch are a challenging condition. Thoracic endovascular aortic repair (TEVAR) with fenestration, which expands the proximal landing zone, is able to exclude the injury while preserving blood flow in supra-aortic branches.
METHODS: Here we report a case of TEVAR with fenestrations of all supra-aortic branches for traumatic aortic pseudoaneurysm and perform a systematic review.
RESULTS: A 24-year-old man suffering a blunt thoracic injury and a left femoral fracture was sent to our hospital. A pseudoaneurysm was found in the aortic arch between the brachiocephalic artery and the left common carotid artery. The patient underwent emergent TEVAR with fenestrations of all supra-aortic branches, which excluded the pseudoaneurysm and preserved the patency of all branches. The orthopedic team then treated the femoral fracture. The patient\'s recovery was unremarkable. We performed a systematic review on TEVAR with fenestrations for BTAI. Six patients (75%) received TEVAR with single fenestration, 1 patient (12.5%) received TEVAR with two fenestrations, and 1 patient (12.5%) had fenestrations of all supra-aortic branches. Except one patient died in the perioperative, other patients survived without stent-related complications in the short-term follow-up.
CONCLUSIONS: TEVAR with fenestration is feasible for treating BTAI involving the aortic arch in selected patients.
METHODS: Here we report a case of TEVAR with fenestrations of all supra-aortic branches for traumatic aortic pseudoaneurysm and perform a systematic review.
RESULTS: A 24-year-old man suffering a blunt thoracic injury and a left femoral fracture was sent to our hospital. A pseudoaneurysm was found in the aortic arch between the brachiocephalic artery and the left common carotid artery. The patient underwent emergent TEVAR with fenestrations of all supra-aortic branches, which excluded the pseudoaneurysm and preserved the patency of all branches. The orthopedic team then treated the femoral fracture. The patient\'s recovery was unremarkable. We performed a systematic review on TEVAR with fenestrations for BTAI. Six patients (75%) received TEVAR with single fenestration, 1 patient (12.5%) received TEVAR with two fenestrations, and 1 patient (12.5%) had fenestrations of all supra-aortic branches. Except one patient died in the perioperative, other patients survived without stent-related complications in the short-term follow-up.
CONCLUSIONS: TEVAR with fenestration is feasible for treating BTAI involving the aortic arch in selected patients.
摘要：
目的：累及主动脉弓的钝性胸主动脉损伤（BTAI）是一种具有挑战性的疾病。胸主动脉腔内修复术（TEVAR）与开窗术，扩大了近端着陆区，能够排除损伤，同时保留主动脉上分支的血流。
方法：在这里，我们报告一例TEVAR，所有主动脉上分支的开窗治疗外伤性主动脉假性动脉瘤，并进行系统评价。
结果：一名24岁男子胸部钝性损伤，左股骨骨折被送往我院。在头臂动脉和左颈总动脉之间的主动脉弓中发现了假性动脉瘤。患者接受了所有主动脉上分支开窗的紧急TEVAR，排除了假性动脉瘤并保留了所有分支的通畅性。然后，骨科小组对股骨骨折进行了治疗。病人的恢复并不显著。我们对TEVAR进行了系统评价，并对BTAI进行了开窗。六名患者（75％）接受TEVAR单开窗术，1例患者（12.5％）接受TEVAR，有两个开窗，1例患者（12.5％）有所有主动脉上分支的开窗。除了一名患者在围手术期死亡，其他患者在短期随访中存活,无支架相关并发症.
结论：TEVAR联合开窗术治疗部分患者中累及主动脉弓的BTAI是可行的。
方法：在这里，我们报告一例TEVAR，所有主动脉上分支的开窗治疗外伤性主动脉假性动脉瘤，并进行系统评价。
结果：一名24岁男子胸部钝性损伤，左股骨骨折被送往我院。在头臂动脉和左颈总动脉之间的主动脉弓中发现了假性动脉瘤。患者接受了所有主动脉上分支开窗的紧急TEVAR，排除了假性动脉瘤并保留了所有分支的通畅性。然后，骨科小组对股骨骨折进行了治疗。病人的恢复并不显著。我们对TEVAR进行了系统评价，并对BTAI进行了开窗。六名患者（75％）接受TEVAR单开窗术，1例患者（12.5％）接受TEVAR，有两个开窗，1例患者（12.5％）有所有主动脉上分支的开窗。除了一名患者在围手术期死亡，其他患者在短期随访中存活,无支架相关并发症.
结论：TEVAR联合开窗术治疗部分患者中累及主动脉弓的BTAI是可行的。
