Thoracic endovascular aortic repair (TEVAR) in a combined penetrating thoracic aortic and spinal cord injury

Endovascular repair of aortic injuries secondary to blunt trauma has been widely described. However, literature on endovascular management in penetrating aortic injuries is scarce. The patient in this case report, a victim of penetrating thoracic aortic trauma, presented 5 days after injury with Brown-Sequard syndrome and a contained aortic injury (pseudoaneurysm) and was haemodynamically stable. Therefore, thoracic endovascular aortic repair was an option in this case. Endovascular repair carries a lower peri-operative morbidity and mortality rate than open repair. However, because most cases of penetrating thoracic vascular injury have haemodynamic instability, open surgery is considered the standard of care. This case demonstrates successful management of an aortic injury with a minimally invasive procedure.