초록접수 현황
| 17F-025 | 포스터 발표 |
Successful Endovascular Repair of Occlusive Traumatic Aortic Injury: Kissing-stent
Up Huh, Seon Hee Kim, Sung Woon Chung, Sang-pil Kim, Seunghwan Song, Miju Bae, Chung Won Lee
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Republic of Korea
Purpose : The kissing stent has been mainly performed in aortoiliac occlusive disease. We report our experience using the kissing stent technique in blunt traumatic aortic injury.
Methods : A 47-year-old man presented to the emergency department (ED) after a high-speed motor vehicle accident involving impact on driver’s side. He was hemodynamically stable (initial blood pressure 180/100 mmHg, pulse 85 bpm, SpO2 100%) and alert (GCS 15) at the time to the ED. Multiple injuries were found on CT scan including thrombotic occlusion in terminal aorta, duodenal perforation, colon injury, and right distal tibia fracture. We figured that traumatic aortic injury was the thrombotic occlusion in bifurcation of terminal aorta. Y-graft interposition had no regard because graft infection could be caused by duodenal perforation, and meso-colon rupture. The endovascular repair with kissing-stent was performed after the exploratory laparotomy. After stent deployment, concomitant post-dilatation was performed using the kissing balloon technique.
Results : The recanalization of terminal aorta and both CIA was confirmed by complete angiograms and the pulsation of both femoral arteries was achieved. In immediate postoperative periods, Urine output was decreased and rhabdomyolysis was diagnosed with acute renal injury because of the compartment syndrome of left thigh. Continuous renal replacement therapy was promptly performed and acute renal injury was fully recovered before discharge. As of 12 months after the procedure, he remains alive and the patency of kissing stents was intact.
Conclusion : We think that the kissing stent could be help to treatment of blunt traumatic aortic injury in terminal
Methods : A 47-year-old man presented to the emergency department (ED) after a high-speed motor vehicle accident involving impact on driver’s side. He was hemodynamically stable (initial blood pressure 180/100 mmHg, pulse 85 bpm, SpO2 100%) and alert (GCS 15) at the time to the ED. Multiple injuries were found on CT scan including thrombotic occlusion in terminal aorta, duodenal perforation, colon injury, and right distal tibia fracture. We figured that traumatic aortic injury was the thrombotic occlusion in bifurcation of terminal aorta. Y-graft interposition had no regard because graft infection could be caused by duodenal perforation, and meso-colon rupture. The endovascular repair with kissing-stent was performed after the exploratory laparotomy. After stent deployment, concomitant post-dilatation was performed using the kissing balloon technique.
Results : The recanalization of terminal aorta and both CIA was confirmed by complete angiograms and the pulsation of both femoral arteries was achieved. In immediate postoperative periods, Urine output was decreased and rhabdomyolysis was diagnosed with acute renal injury because of the compartment syndrome of left thigh. Continuous renal replacement therapy was promptly performed and acute renal injury was fully recovered before discharge. As of 12 months after the procedure, he remains alive and the patency of kissing stents was intact.
Conclusion : We think that the kissing stent could be help to treatment of blunt traumatic aortic injury in terminal
책임저자: Chung Won Lee
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Republic of Korea
발표자: Up Huh, E-mail : tymfoo82@gmail.com