PMC10438978_01
Axial computed tomography scan of the chest performed on a 65-year-old male patient after a frontal collision accident. Aortic dissection is observed at the level of the arch and proximal third of the descending aorta.
CRIOR2023-8918724.001.jpg
PMC10438978_01_CRIOR2023-8918724.001.jpg
fig1
Results show evident injury at the level of the aortic arch and descending portion, without data of spinal compromise (Figure 1).
3D reconstruction of a segmental fracture of the distal 1/3 of the right femur AO 32C3k (treated with external fixators) and intertrochanteric fracture AO 31A1.3.
CRIOR2023-8918724.002.jpg
PMC10438978_01_CRIOR2023-8918724.002.jpg
fig2
It is worth mentioning that this procedure is performed without anesthesia due to the paraplegia presented by the patient (Figure 2).
Axial and sagittal section of the thorax and abdomen with intravenous contrast, with angiotomography protocol where dissection is observed at the level of the aortic arch, distal to the emergence of the supra-aortic stems (DeBakey III) with extravasation of the contrast medium into the false lumen, and extension until the emergence of the celiac trunk.
CRIOR2023-8918724.003.jpg
PMC10438978_01_CRIOR2023-8918724.003.jpg
fig3
The dissection is classified as type IIIb DeBakey, Stanford type B (Figure 3).
Fluoroscopic image of endovascular prosthesis placement.
CRIOR2023-8918724.004.jpg
PMC10438978_01_CRIOR2023-8918724.004.jpg
fig4
Endovascular prostheses placement in the hemodynamics area is decided (Figure 4).
Post-surgical X-ray of the right femur after osteosynthesis with proximal femoral nail and distal femur anatomical plate.
CRIOR2023-8918724.005.jpg
PMC10438978_01_CRIOR2023-8918724.005.jpg
fig5
Three days after admission, the osteosynthesis of the right femur is performed with proximal femoral nail and anatomical plaque of the distal femur (Figure 5), without incidents or accidents during surgery, after the surgical event a globular package is transfused.
Post-surgical angiomesenteric tomography, an aortic endoprosthesis is observed in the aortic arch and descending portion. No data on intramural hematomas or extravasation of contrast at the time of the study.
CRIOR2023-8918724.006.jpg
PMC10438978_01_CRIOR2023-8918724.006.jpg
fig6