INTRAVASCULAR STENTING OF TRAUMATIC ABDOMINAL AORTIC DISSECTION

Purpose: We describe the case of a 34-year-old man with blunt abdomina l trauma. Initial abdominal computed tomography scan showed retroperit oneal hematoma, pancreatic contusion, multiple fractures of the transv erse process in the thoraco-lumbar spine, and infrarenal aortic dissec tion. Method: Angiography revealed that the aortic dissection originat ed proximal to the inferior mesenteric artery and extended down to the left common iliac artery without vascular obliteration. The pancreati c trauma was managed without operation, and the dissection was treated with aortic and left iliac endovascular self-expanding Schneider Wall Stents. Result: Immediate angiographic and computed tomography scan e xamination showed the obliteration of the greater part of the dissecti on with persistence of a short dissected segment at the level of the a ortic bifurcation. Examination a week later showed thrombosis of this false lumen and complete obliteration of the dissection. Conclusion: I ntravascular stenting allowed treatment of the dissection without open surgical procedures requiring laparotomy and aortic operation.