Successful management of a delayed presentation of traumatic descending thoracic aorta pseudoaneurysm: a literature review based on a case report
Dublin Core
Title
Successful management of a delayed presentation of traumatic descending thoracic aorta pseudoaneurysm: a literature review based on a case report
Subject
Transthoracic echocardiography, Non-invasive cardiovascular imaging, Aortic pseudoaneurysm,
Interventional cardiology, Endovascular repair, Cardiac trauma
Interventional cardiology, Endovascular repair, Cardiac trauma
Description
Abstract
Background Blunt traumatic aortic injury (BTAI) is the second leading cause of death due to traumas in young
patients. The primary presentation might be chest or interscapular pain, difficulty in breathing, and, in severe cases,
hypotension. Considering the rapid deterioration of these patients’ clinical conditions, prompt diagnosis and treat-
ment initiation are crucial. In these injuries, the most involved parts of the aorta are the isthmus (distal to the left sub-
clavian artery) and the descending part in the thorax. Therefore, the main diagnostic strategies include transthoracic
echocardiography, CT angiography, and endovascular diagnostic approaches.
Case presentation
The patient was a 19-year-old male presenting with the symptoms of chest pain, dyspnea, and extremities excruciat-
ing pain after a car turnover. The initial evaluation showed no abnormal cardiovascular finding except bilateral hemo-
thorax, addressed with chest tubes. Twelve hours later, when the patient was under observation for orthopedic sur-
geries, his chest pain and dyspnea started, and TTE and CTA showed a grade three descending aneurysm of the aorta.
The patient was treated immediately with an endovascular procedure of stent implantation. A delayed debranching
surgery was also performed, which resulted in desirable outcomes and uneventful follow-up.
Conclusion Although open thoracic surgery is the main and almost the only option for treating aneurysms
of the aorta in hemodynamically unstable patients, the endovascular procedure has shown superior outcomes
in selected patients with appropriate anatomy. Debranching surgery, which can be done simultaneously or with delay
after the initial procedure, has proven protective against thromboembolic cerebral events.
Clinical key point Patients with an aneurysm of the aorta should be transported to a medical center with a multidis-
ciplinary team for an urgent evaluation and treatment. The initial resuscitation and diagnosis are challenging, consid-
ering the fatal nature of these injuries, and the selection of the treatment is based on the patient’s clinical condition
and evaluated anatomy in cardiovascular imaging.
Keywords Transthoracic echocardiography, Non-invasive cardiovascular imaging, Aortic pseudoaneurysm,
Interventional cardiology, Endovascular repair, Cardiac trauma
Background Blunt traumatic aortic injury (BTAI) is the second leading cause of death due to traumas in young
patients. The primary presentation might be chest or interscapular pain, difficulty in breathing, and, in severe cases,
hypotension. Considering the rapid deterioration of these patients’ clinical conditions, prompt diagnosis and treat-
ment initiation are crucial. In these injuries, the most involved parts of the aorta are the isthmus (distal to the left sub-
clavian artery) and the descending part in the thorax. Therefore, the main diagnostic strategies include transthoracic
echocardiography, CT angiography, and endovascular diagnostic approaches.
Case presentation
The patient was a 19-year-old male presenting with the symptoms of chest pain, dyspnea, and extremities excruciat-
ing pain after a car turnover. The initial evaluation showed no abnormal cardiovascular finding except bilateral hemo-
thorax, addressed with chest tubes. Twelve hours later, when the patient was under observation for orthopedic sur-
geries, his chest pain and dyspnea started, and TTE and CTA showed a grade three descending aneurysm of the aorta.
The patient was treated immediately with an endovascular procedure of stent implantation. A delayed debranching
surgery was also performed, which resulted in desirable outcomes and uneventful follow-up.
Conclusion Although open thoracic surgery is the main and almost the only option for treating aneurysms
of the aorta in hemodynamically unstable patients, the endovascular procedure has shown superior outcomes
in selected patients with appropriate anatomy. Debranching surgery, which can be done simultaneously or with delay
after the initial procedure, has proven protective against thromboembolic cerebral events.
Clinical key point Patients with an aneurysm of the aorta should be transported to a medical center with a multidis-
ciplinary team for an urgent evaluation and treatment. The initial resuscitation and diagnosis are challenging, consid-
ering the fatal nature of these injuries, and the selection of the treatment is based on the patient’s clinical condition
and evaluated anatomy in cardiovascular imaging.
Keywords Transthoracic echocardiography, Non-invasive cardiovascular imaging, Aortic pseudoaneurysm,
Interventional cardiology, Endovascular repair, Cardiac trauma
Creator
Mohammad Sadeghian1
, Pouya Ebrahimi2
, Parnian Soltani2
, Massoud Ghasemi3
, Homa Taheri4 and
Maryam Mehrpooya5*
, Pouya Ebrahimi2
, Parnian Soltani2
, Massoud Ghasemi3
, Homa Taheri4 and
Maryam Mehrpooya5*
Source
https://doi.org/10.1186/s12245-024-00670-w
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Mohammad Sadeghian1
, Pouya Ebrahimi2
, Parnian Soltani2
, Massoud Ghasemi3
, Homa Taheri4 and
Maryam Mehrpooya5*, “Successful management of a delayed presentation of traumatic descending thoracic aorta pseudoaneurysm: a literature review based on a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12390.