DEMOGRAPHICS: The patient is a 19-year-old otherwise healthy male with a history significant for cocaine abuse who initially presented to our hospital with blunt traumatic aortic injury (BTAI) after a motor vehicle accident.
HISTORY: We discuss the case of a 19-year-old who presented with acute onset heart failure and renal failure secondary to a thrombosed aortic stent graft. This was placed eight months prior to presentation for a blunt traumatic aortic injury after a motor vehicle accident.
PLAN: He underwent endovascular repair with a Gore TAG graft, which was deployed with overlap of the thrombosed segment and only minimal additional aortic coverage. There was residual narrowing after graft deployment, which was successfully managed with a Tri Lobe balloon.
DISCUSSION: Blunt thoracic aortic injuries (BTAI) are rare, but potentially fatal injuries that often require urgent or emergent repair. Thoracic endovascular aortic repair has become the preferred treatment method for BTAI over open surgical repair due to fewer complications and lower mortality rates. However, its use and long-term outcomes in the younger, trauma patient population have not been well studied. Our patient underwent successful endovascular repair with resolution of his acute heart and renal failure but suffered from lower extremity motor deficits for several months after the procedure. Surveillance imaging at 6 months, 1 year, and 3 years later demonstrate patent aortic stent grafts. In this case report, we demonstrate that there is an opportunity for endovascular salvage for occluded TEVAR in a young patient.