Successful Revascularization of Aortic Arch in a 39-Year-Old Blunt Trauma Patient with Acute Diffuse Axonal Injury without the Use of Systemic Anticoagulation

Annals of Vascular Surgery
Andrew M Abi-ChakerJorge Rey

Abstract

Blunt traumatic aortic injury is the second leading cause of death in trauma patients aged 4-34 years. Of the patients who are able to receive treatment, mortality rates as high as 40% have been reported. Endovascular repair options have allowed for more expeditious repairs with reduced iatrogenic trauma; however, when the injury involves the ascending aorta or arch, current endografts lack fenestrations needed for cerebral blood flow. Traditionally, on pump, cardiopulmonary bypass with systemic anticoagulation has been used to repair these injuries. In this paper, we describe a unique case of repairing a large traumatic aortic arch pseudoaneurysm in the setting of which systemic anticoagulation is contraindicated. The patient is a 39-year-old otherwise healthy Hispanic male who presented to Ryder Trauma Center in Miami, Florida, following a motor vehicle collision and found to have multiple intracranial hemorrhages and a large aortic pseudoaneurysm of the distal ascending aorta. In lieu of standard cardiopulmonary bypass, a hybrid approach was utilized. Cranial blood flow was maintained using a temporary extra-anatomical left femoral to bilateral carotid bypass during endovascular coverage of the aortic arch. Aortic arch revas...Continue Reading

References

May 23, 2014·Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society·Anna ZisbergTova Band-Wintershtein

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