Open Treatment of Blunt Injuries of Supra-Aortic Branches: Case Series

• Published in: Annals of vascular surgery Vol. 31; pp. 205.e5 - 205.e10
• Main Authors: Sladojevic, Milos, Markovic, Miroslav, Ilic, Nikola, Pejkic, Sinisa, Banzic, Igor, Djoric, Predrag, Koncar, Igor, Tomic, Ivan, Davidovic, Lazar
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-02-2016
• Subjects: Adult; Aneurysm, False - diagnosis; Aneurysm, False - etiology; Aneurysm, False - surgery; Angiography, Digital Subtraction; Aorta - injuries; Aorta - surgery; Aortic Aneurysm - diagnosis; Aortic Aneurysm - etiology; Aortic Aneurysm - surgery; Aortography - methods; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - instrumentation; Humans; Male; Middle Aged; Multidetector Computed Tomography; Polyethylene Terephthalates; Polytetrafluoroethylene; Prosthesis Design; Surgery; Thoracic Injuries - diagnosis; Thoracic Injuries - etiology; Thoracic Injuries - surgery; Treatment Outcome; Vascular System Injuries - diagnosis; Vascular System Injuries - etiology; Vascular System Injuries - surgery; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - etiology; Wounds, Nonpenetrating - surgery
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2015.07.049

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.