TEVAR and Delayed Left Subclavian Artery Chimney for Thoracic Aortic Transection
Keywords:emergent TEVAR, vascular surgery trauma, vascular surgery
A 57 years old male presented to the ED with blunt trauma due to a high fall. On presentation the patient was unstable (Systolic BP- 70, HR -120). The procedure was performed in two sessions. An emergency deployment of a Zenith Alpha (COOK Medical) thoracic endo-graft in the descending thoracic aorta with intentional covering of the left subclavian artery. The patient was stabilized in ICU. Due to left upper limb ischemia a parallel "chimney" Be-Graft (BENTLEY) covered balloon expandable stent was deployed in the left subclavian artery (retrograde approach) after 24 hours from the index procedure. Patient was mobilized with complete recovery after 48 hours. Completion CTA revealed complete resolution of the thoracic rupture with patent left subclavian "chimney" stent.