Seat belt aorta: Endovascular management with a stent-graft

Purpose: To report the endovascular treatment of a relatively uncommon type of deceleration injury to the abdominal aorta. Case Report: A 21-year-old backseat passenger was wearing a single lap belt without shoulder harness when the car was involved in a collision. He sust ained a transverse (Chance) fracture of the third lumbar vertebra and a cir cumferential dissection of the infrarenal abdominal aorta with pseudoaneury sm. As an interim measure while a stent-graft was obtained, a Wallstent was deployed to tack down the dissection and prevent distal embolization. Thir ty-six hours later, an AneuRx endograft was successfully implanted inside t he Wallstent to seal the pseudoaneurysm. The patient's recovery was unevent ful, and the endograft remains secure and the pseudoaneurysm excluded at 10 months after the accident. Conclusions: Endovascular repair of "seat belt aorta" is a minimally invasi ve, straightforward method of management for this type of aortic injury. Th e potential for infection in a contaminated peritoneal cavity and the long- term outcome of this treatment have not been determined.