Emergency endovascular treatment of traumatic aortic arch rupture with multiple arch vessel involvement.

Objective: To report successful endovascular stent-graft placement for emergency treatment of a complex traumatic injury involving the aortic arch and multiple arch vessels.

Methods: An 81-year-old man underwent stent-graft placement for a complex traumatic vascular injury. Computed tomography on admission documented a dissection along the course of the aortic arch, intramural hematoma along the ascending aorta, dissection of the innominate artery, and a right subclavian artery pseudoaneurysm. The dissection of the aortic arch and the pseudoaneurysm of the right subclavian artery were treated immediately, the dissection of the innominate artery 7 days later. The patient did not develop any complications. Follow-up studies performed prior to discharge and at 6 and 12 months after the interventions showed successful repair of the complex vascular injuries.

Conclusions: Traumatic injury of the aortic arch with multiple arch vessel involvement can be treated effectively by means of stent-graft placement.