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Published on: March 28, 2025
[Thoracic Endovascular Aneurysm Repair Using the Concomitant Chimney Technique for Blunt Thoracic Aortic
Hiromitsu Nota1, Keiji Matsubayashi, Kentarou Matsuoka
1Department of Cardiovascular Surgery, Ohmihachiman Community of Medical Center, Ohmihachiman, Japan.
Abstract:
Blunt thoracic aortic injury (BTAI) is associated with high morbidity and mortality. Recently, minimally invasive thoracic endovascular aortic repair (TEVAR) has been reported to be a safe surgical treatment for acute BTAI. Here, we report the success of TEVAR using the concomitant chimney technique for BTAI. A 70-year-old man in shock was referred to our emergency room following a traffic accident. Computed tomography( CT) scan demonstrated multiple rib fractures, hemothorax, and BTAI. According to the severity of BTAI as classified by the Society for Vascular Surgery( SVS) guidelines, the patient was diagnosed with grade 4 free rupture. We performed TEVAR twice because of the endoleak; however, this method saved the patient's life. The use of the chimney technique to preserve the patency of the left subclavian artery is beneficial because the majority of BTAI cases occur in the aortic isthmus from a pathophysiological perspective.
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