Undersized Stentgraft Placement for Traumatic Descending Aorta Rupture, and What Is Next?

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Endovascular Interventions

Background:

• Traumatic thoracic aortic injury is a leading cause of death and necessitates urgent vascular intervention.
• Endovascular aortic repair (TEVAR) is increasingly utilized for traumatic aortic injuries.

Observation:

• A 20-year-old male with a traumatic descending aorta rupture underwent emergent thoracic endovascular aortic repair (TEVAR).
• The patient required reintervention 30 days post-TEVAR due to a type-I endoleak from failed stentgraft deployment.

Findings:

• A hybrid procedure successfully excluded the aortic rupture by removing mismatched equipment and deploying an appropriately sized stentgraft.
• Endovascular repair in small-framed adults presents challenges due to lack of dedicated equipment and difficulties in sizing.

Implications:

• The initial TEVAR served as a life-saving measure, with a subsequent procedure providing a definitive solution.
• Standardized protocols and specialized devices are needed for effective endovascular treatment of traumatic aortic injuries in pediatric and small-framed adult populations.