Endovascular and surgical treatment of a patient with traumatic rupture of the aorta and hepatic artery

Chernaya N.R., Muslimov R.Sh., Selina I.E., Kokov L.S., Vladimirova E.S., Navruzbekov M.S., Gulyaev V.A.

Department of Roentgenosurgical Methods of Diagnosis and Treatment, Scientific Research Institute of Emergency Ambulance Care named after N.V. Sklifosovsky, Moscow, Russia

Traumatic rupture of the aorta is the second most common cause of death in closed chest injury. The latest findings of autopsy showed that 80% of lethal outcomes in aortic injury occur in the prehospital period. Taking into consideration the incidence and high rate of death prior to the diagnosis stage, aortic rupture in closed thoracic injury is an important problem. Due to the characteristic mechanism of the development (during sharp deceleration of the body) this type of traumatic lesion of the aorta became known as "deceleration syndrome". The most vulnerable to tension aortic portion is its neck where the mobile part of the thoracic aorta is connected to the fixed arch in the place of the arterial ligament attachment.

Open surgical intervention in patients with severe closed chest injury (often concomitant injury) is associated with high mortality and complications. Currently endovascular prosthetic repair of the aorta is a method of choice at the primary stage of treatment of patients with aortic injury. In this article we present a rare case report of concomitant lesion of large vessels (the descending aortic portion and proper hepatic artery) in a patient with severe concomitant injury, as well as peculiarities of diagnosis and combined treatment (endovascular prosthetic repair of the aorta and hepatic artery with an aotovein).

KEY WORDS: traumatic rupture of the thoracic aorta, endovascular treatment, traumatic lesion of hepatic artery, surgical treatment.

P. 181

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