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      Is Open Access

      Blunt Traumatic Innominate Artery Pseudoaneurysm Endografting without Heparin Due to Severe Brain Injury

      case-report

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          Abstract

          Blunt traumatic innominate artery injuries occur in polytrauma victims who have suffered high-speed motor vehicle collisions. Their associated injuries may preclude the use of heparin and affect surgical management and perioperative neurological risk. The uniqueness of this case is combining the arterial injury repair with a severe progressive neurological injury that prohibited standard perioperative antiplatelet or anticoagulent use.

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          Rupture of the innominate artery from blunt trauma: current options for management.

          John Symbas, Michael Halkos, Panagiotis N Symbas (2016)
          Rupture of the innominate artery is the second most common intrathoracic arterial injury from blunt trauma. It is frequently accompanied by major trauma to other organs. The traditional management is expeditious surgical repair. Three patients presented to the Emergency Department after motor vehicle collisions with traumatic rupture of the innominate artery from 2001 to 2003. One patient presented with an isolated innominate artery injury. The other two patients presented with multi-system trauma. All patients underwent surgical repair; however, repair was individualized in each case. Diagnosis was obtained via arteriography in all patients after the admission chest radiographs suggested mediastinal injury. In the patient with isolated traumatic innominate artery rupture, urgent repair was performed. In the remaining two, the repair was intentionally delayed (hospital day 4 and 19) until they stabilized or recovered from other injuries or complications. In one of these patients, repair was delayed after an endovascular repair failed. In both patients who underwent delayed repair, mean arterial pressure was maintained at <70 mmHg with beta-blockade. All patients underwent repair without cardiopulmonary bypass and were monitored for adequate cerebral perfusion pressures by measuring the right carotid artery stump pressure. Successful repair was achieved in all the three patients without postoperative complications or mortality. Rupture of the innominate artery from blunt trauma is an infrequent but life-threatening injury that mandates repair. In patients with isolated injuries, prompt intervention is warranted. However, intentional delayed repair may be a practical alternative for those patients with multi-system trauma.
          Article 0 comments Cited 6 times – based on 0 reviews     Review now
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            Traumatic rupture of the innominate artery.

            R DuBose, S. King, Riyad Karmy-Jones (2003)
            Blunt traumatic rupture of the innominate artery is uncommon. We reviewed our experience to correlate the impact of patient stability, presence of associated injuries and location of the injury within the artery with outcome. A retrospective review was performed of patients admitted between January 1, 1998 and December 17, 2002 with traumatic innominate artery rupture. Injuries were defined as proximal if they were
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              Blunt injury of the innominate artery: a case report and review of literature.

              Inderjit S Gill, Hitoshi Hirose (2004)
              Innominate artery injury after blunt trauma is uncommon and mostly observed at its origin from the aorta. We report here an unusual case of distal innominate artery injury associated with acute right subclavian occlusion. MEDLINE search of blunt traumatic injury to the innominate artery revealed a total of 132 case reports by the end of 2003, including this case report, and all these published studies were reviewed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Aorta (Stamford)
                Journal ID (iso-abbrev): Aorta (Stamford)
                Journal ID (doi): 10.1055/s-00039245
                Title: AORTA Journal
                Publisher: Thieme Medical Publishers, Inc. (333 Seventh Avenue, 18th Floor, New York, NY 10001, USA )
                ISSN (Electronic): 2325-4637
                Publication date (Electronic): 31 May 2022
                Publication date Collection: February 2022
                Publication date PMC-release: 1 May 2022
                Volume: 10
                Issue: 1
                Pages: 32-34
                Affiliations
                [1 ]Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
                [2 ]Department of Surgery, Weill Cornell Medicine, Flushing, New York
                Author notes
                Address for correspondence Charles A. Mack, MD New York-Presbyterian Medical Group Queens 56-45 Main Street, 3S—376, Flushing, NY 11355 cmack@ 123456med.cornell.edu
                Author information
                http://orcid.org/0000-0001-8142-9818
                Article
                Publisher ID: 200073
                DOI: 10.1055/s-0041-1739486
                PMC ID: 9179206
                PubMed ID: 35640585
                SO-VID: 3285becb-80fb-4e86-a517-85f11bc3c18a
                Copyright © The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ )
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 28 November 2020
                Date accepted : 02 July 2021
                Funding
                Funding None.
                Categories
                Subject: Case Report

                Keywords: innominate artery pseudoaneurysm,blunt trauma,neurological injury
                Data availability:
                Keywords: innominate artery pseudoaneurysm, blunt trauma, neurological injury

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