Thoracic aortic aneurysms after blunt trauma

BACKGROUND Aortic injury after blunt trauma that is missed during the first admission will soon be seen as a chronic aneurysm. The objective of this study is to show the importance of the diagnosis and appropriate treatment of these aneurysms. METHODS Between 2009 and 2012, 8 patients (mean age, 50 +/- 31 years) diagnosed with chronic traumatic aortic aneurysm were treated with either thoracic endovascular aortic repair (TEVAR) or conventional surgery 20 years on average after the trauma. RESULTS Treatments included TEVAR in four patients, conventional surgery in two patients, and hybrid intervention in one patient. One patient died postoperatively. One patient had an endoleak requiring a repeat TEVAR, which was successful. Brachial embolectomy was performed after placing the endovascular stent. No paraplegia or lower extremity ischemia was seen. One patient died preoperatively due to rupture of the aneurysm. CONCLUSION Chronic traumatic aortic aneurysms may cause general symptoms years after a blunt trauma. Aortic injury must always be considered in the assessment and follow-up of trauma patients.