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首页> 外文期刊>Vascular and endovascular surgery >Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report
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Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report

机译：无名的动脉钝伤：期待什么惊喜？ 案例报告

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摘要

Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation. The patient underwent emergent angiography, which confirmed that the IA dissection was not ruptured, but it was unclear whether there was a pseudoaneurysm at the origin of the IA or aortic arch involvement. The patient was considered for open surgery. An ascending aorta-to-IA bypass was achieved by the off-pump beating heart approach. The IA stump was carefully observed, but oversewing was not possible due to the extension of the intimal-medial lesions into the artic arch. An on-pump intervention was then required for aortic angioplasty with a pericardial patch that was reinforced by Gel Seal. The postoperative course was uneventful. The patient was discharged without any complications. Conventional surgery provides good results and should remain in the armamentarium for the treatment of traumatic lesions at the IA origin, particularly if aortic arch involvement cannot be ruled out, to ensure a truly patient-tailored approach.
机译：钝性胸部创伤后的同上主动脉躯干的伤害很少见。这是一个案例报告的钝性动脉（IA）原产地的钝性病变，其表现出主动脉弓参与，重点是成像和治疗。一位41岁的渔夫介绍了次级的IA损伤，以高抗冲击胸部创伤。体检时，生命体征稳定，存在上肢脉冲。除了几种骨折（肋骨肋骨，绞线，肩胛骨，颞，上颌和蝶形）外，计算断层造影血管造影揭示了IA的剖析/假肿瘤抑制分叉分叉。患者接受了紧急血管造影，证实IA解剖未破裂，但目前尚不清楚IA或主动脉弓受累的起源中是否存在假肿瘤。患者被认为是开放的手术。通过外泵击打心脏方法实现了升高的主动脉到IA旁路。仔细观察IA树桩，但由于延伸了内侧内侧病变进入艺术拱门的延伸，不可能。然后需要具有通过凝胶密封加固的心动膜的主动脉血管成形术需要在泵干预。术后过程很顺利。病人没有任何并发​​症。常规手术提供了良好的结果，并且应留在IA起源中的创伤病变的武器中，特别是如果无法排除主动脉弓，以确保真正患者量身定制的方法。

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