Related Experiment Video
Updated: Mar 29, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Open Treatment of Blunt Injuries of Supra-Aortic Branches: Case Series
Milos Sladojevic1, Miroslav Markovic2, Nikola Ilic2
1Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
Insights
Blunt injuries to supra-aortic arteries are rare but life-threatening. Open surgical repair, including bypass grafting, can be a successful treatment option when endovascular methods are unavailable.
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Cardiovascular Surgery
Background:
- Blunt injuries to the supra-aortic branches are uncommon and often fatal before hospital admission.
- Survivors require immediate, complex surgical intervention, frequently necessitating sternotomy.
- This report details three successfully managed cases of blunt supra-aortic vessel injury.
Observation:
- Case 1: Urgent repair of a longitudinal rupture in the innominate artery following a car accident.
- Cases 2 & 3: Management of chronic false aneurysms at the origins of the right subclavian and left common carotid arteries.
- All cases involved patients where endovascular treatment options were not available at the facility.
Findings:
- Two patients underwent bypass grafting using a custom Dacron graft from the ascending aorta to the innominate artery, right common carotid, and right subclavian arteries.
- One patient received bypass grafting from the ascending aorta to the cervical portion of the left common carotid artery.
- All three patients were successfully treated with open surgical repair.
Implications:
- Open surgical repair of blunt supra-aortic vessel injuries is a viable and complication-free option when endovascular techniques are inaccessible.
- The study highlights the effectiveness of traditional surgical methods in managing complex vascular trauma.
- Endovascular and hybrid procedures should be prioritized when available for treating these injuries.
Background:
Blunt injuries of the supra-aortic branches are rare entity, and majority of patients die before arrival at the hospital. Those who arrive alive require complex and fast procedure that requires sternotomy. We report 3 successfully managed cases.
Case Reports:
We report 3 patients with injury of supra-aortic branches. One was treated urgently due to longitudinal rupture on the posterior wall of innominate artery after car accident, and another 2 had chronic false aneurysm located at the very orifice of the right subclavian and left common carotid artery. In first and second patient bypass grafting with a hand-made, Y-shaped, 8-mm Dacron graft from the ascending aorta to the right common carotid and proximal right subclavian artery were performed, whereas in last 1 bypass grafting from the ascending aorta to the cervical part of the left common carotid artery was performed. In our facility, there were no possibilities for any endovascular treatment.
Conclusions:
When endovascular technology is not available, open surgical repair of blunt injuries of supra-aortic vessels can be performed without complications. No matter to that, endovascular and hybrid procedures should be considered whenever possible.
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:26Aneurysm III: Interprofessional Care
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:22Aneurysm IV: Nursing Management