Transection of the thoracic aorta: current treatment obstacles

A 19-year-old female driver involved in a head on collision suffered a transection of her thoracic aorta secondary to blunt trauma. She was transported to the trauma center where a chest x-ray showed a widened mediastinum. IV contrast enhanced CT of the chest showed extravasation of contrast medium into the mediastinum. She was taken to the operating room for immediate and successful open surgical repair. Historically open repair of aortic transaction was the mainstay of treatment. Currently thoracic endovascular aortic repair (TEVAR) may be a preferable method at many institutions. However the current devices are designed for aneurysmal disease and size may limit their use.