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Five percent of patients with BTAI present with aortic rupture that can cause early death in the acute phase, making early operative management a necessity [3].
Conservative therapy and close observation were applied for the subarachnoid hemorrhage and BTAI. After 6 hours of observation, CT was performed again and the subarachnoid hemorrhage appeared not to progress.
Blunt thoracic aortic injury (BTAI) frequently occurs in the isthmus of the aorta and accounts for 93% of all BTAI [6].
Emergency surgery in patients with unstable hemodynamics due to BTAI seems necessary.
In a report, BTAI was graded I-IV; I: intimal injury, II: intramural hematoma, III: pseudoaneurysm, and IV: rupture.
Additionally, BTAI was the injury that was urgently treated.
We applied this knowledge to our treatment of BTAI and performed delayed operation on day 16.
Regarding the surgical modality for BTAI, endovascular surgery is preferable because it is associated with a lower mortality and morbidity.
The objective of this study was to evaluate the limitations and potential adverse effects related to the endovascular management of pseudoaneurysms due to BTAI.
TEVAR is rapidly being accepted as the standard of care to treat BTAI. The evolution of stent grafts and a better understanding of the natural history of the aortic injury are likely to improve outcomes in the future.
There is likely to be a trend towards aggressive TEVAR management in patients with BTAI.
The evolution of TEVAR as the standard of care in patients with BTAI is likely to be associated with long-term complications that we have not yet realised.