PMC6109575_01
Case 1. Preoperative contrast-enhanced computed tomography: (a) axial, (b) sagittal image, and (d) 3-dimensional image. A pseudoaneurysm was observed in the distal aortic arch (arrow mark). (c) Sagittal image in another slice. Thoracic vertebra 12 and lumbar vertebra 1 are fractured.
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Achilles tendon (Figure 1). A drain was placed in the left thorax, and mechanical ventilation was started under sedation.
Case 1. Intraoperative aortography: (a) before deploying the stent graft and (b) a pseudoaneurysm was observed but it disappeared after the stent graft was deployed. Postoperative computed tomography: (c) axial image, (d) sagittal image, and (e) 3-dimensional image. The pseudoaneurysm had disappeared.
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Follow-up with enhanced CT showed that the pseudoaneurysm had disappeared (Figure 2).
PMC6109575_02
Case 2. Preoperative computed tomography: (a) axial image, (b) sagittal image, and (c) sagittal image in another slice. Intraluminal hematoma was observed (arrows).
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Enhanced CT was performed which revealed aortic dissection with intramural hematoma. Extravasation and pseudoaneurysm were not observed (Figure 3).
Case 2. Intraoperative aortography: (a) before deploying the stent graft and (b) after deploying the stent graft. There were no endoleaks. Postoperative computed tomography performed one month after the procedure: (c) axial image, (d) sagittal image, and (e) sagittal image in another slice. The thickness of the intraluminal hematoma had decreased.
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We placed 22 x 22 x 100 mm (Valiant Captivia Thoracic Stent Graft, Medtronic, Medtronic, Santa Rosa, CA) and 30 x 26 x 150 mm (Relay Plus, Bolton Medical, Sunrise, FL) stent grafts (Figure 4). Enhanced CT performed 1 month after the procedure revealed that the thickness of the intraluminal hematoma had decreased (Figure 4).
PMC6109575_03
Case 3. Enhanced computed tomography performed in the emergency room after resuscitation: (a) head axial image, subarachnoid hemorrhage was observed; (b) thoracic axial image, pseudoaneurysm was observed in the distal aortic arch (arrow); and (c) abdominal axial image, free air in the abdomen was observed. Intraoperative aortography: (d) before deploying the stent graft and (e) after deploying the stent graft. There were no endoleaks.
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CT were performed. Contrast-enhanced CT showed subarachnoid hemorrhage, free air in the abdomen, aortic dissection, and a pseudoaneurysm around the distal arch (Figure 5).