Seat Belt Aorta: Endovascular Management with a Stent-Graft

Author:

Fontaine Arthur B.,Nicholls Steven C.1,Borsa John J.,Hoffer Eric1,Bloch Robert D.1,Kohler Ted2

Affiliation:

1. University of Washington, Harborview Medical Center, Seattle, Washington, USA

2. University of Washington Veterans Affairs Medical Center, Seattle, Washington, USA

Abstract

Purpose: To report the endovascular treatment of a relatively uncommon type of deceleration injury to the abdominal aorta. Case Report: A 21-year-old backseat passenger was wearing a single lap belt without shoulder harness when the car was involved in a collision. He sustained a transverse (Chance) fracture of the third lumbar vertebra and a circumferential dissection of the infrarenal abdominal aorta with pseudoaneurysm. As an interim measure while a stent-graft was obtained, a Wallstent was deployed to tack down the dissection and prevent distal embolization. Thirty-six hours later, an AneuRx endograft was successfully implanted inside the Wallstent to seal the pseudoaneurysm. The patient's recovery was uneventful, and the endograft remains secure and the pseudoaneurysm excluded at 10 months after the accident. Conclusions: Endovascular repair of “seat belt aorta” is a minimally invasive, straightforward method of management for this type of aortic injury. The potential for infection in a contaminated peritoneal cavity and the long-term outcome of this treatment have not been determined.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,Surgery

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