Combined Treatment, Endovascular and Surgical Treatment of Postraumatic Pseudoaneurysm in the Aortic Arch

Traumatic rupture of the thoracic aorta has a high mortality. The endovascular alternative has been considered for aortic repair in high-risk patients with multiple trauma. We report a case of a 20 year-old man who suffered a multiple trauma secondary to motor vehicle accident. Arteriography revealed the existence of a pseudoaneurysm at the origin of left common carotid artery.A short and immediate control of the thoracic aorta is needed in cases with active bleeding of the aorta when the patient is unstable. Endovascular treatment as a definitive repair or first control before performing surgical repair seems a good choice.Our experience in this patient suggests that the combined endovascular and surgical treatment can be a valuable therapeutic alternative when treating a blunt aortic lesion. It is less invasive surgery and avoids aortic cross-clamping, circulatory assistance and high dose heparinization.Further studies are required to determine the relevance of the endovascular treatment in the management of traumatic rupture of the aorta in young patients.