Longitudinal Anesthetic and Critical Care Management After Emergency Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury in an Adolescent: A Case Report.
- 1Anesthesiology and Critical Care, Ospedale Antonio Cardarelli, Campobasso, ITA.
Abstract
Blunt thoracic aortic injury (BTAI) is uncommon in children and adolescents but carries substantial early mortality. Thoracic endovascular aortic repair (TEVAR) can provide rapid definitive control in anatomically suitable patients; however, the subsequent course is often driven by associated injuries and evolving critical illness. A previously healthy 14-year-old boy was transferred after a high-energy road traffic collision with a contained injury of the descending thoracic aorta, mediastinal hematoma, left femoral and open tibial fractures, pulmonary contusions, and splenic contusion. Emergency TEVAR with a 24 × 80-mm thoracic endograft achieved complete exclusion without endoleak. External fixation of the long-bone fractures followed. After initial extubation, the patient required reintubation on hospital day 4 for severe hypoxemia with bilateral pulmonary consolidations and left pleural effusion; he was successfully extubated two days later. On day 21, delayed ileocecal perforation with diffuse peritonitis required emergency right hemicolectomy. Definitive femoral and tibial intramedullary fixation and pleural drainage were performed on day 35, followed by percutaneous drainage of a pelvic abscess on day 44. He was discharged home neurologically intact on day 50, with a patent, well-positioned endograft and no endoleak. This case shows that successful TEVAR is one component of a prolonged, physiology-driven perioperative strategy requiring continuity across vascular, orthopedic, abdominal, respiratory, and rehabilitation care.
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BibTeX
@article{cuzzone2026longitudinal,
title = {{Longitudinal Anesthetic and Critical Care Management After Emergency Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury in an Adolescent: A Case Report.}},
author = {Vincenzo Cuzzone and Claudia De Stefano and Giuseppe Manna and Giulia Cama and Amelia Paglia},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116759},
url = {https://europepmc.org/article/MED/42921006},
note = {CC BY},
}
RIS
TY - JOUR
TI - Longitudinal Anesthetic and Critical Care Management After Emergency Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury in an Adolescent: A Case Report.
AU - Vincenzo Cuzzone
AU - Claudia De Stefano
AU - Giuseppe Manna
AU - Giulia Cama
AU - Amelia Paglia
PY - 2026
DA - 2026/09/22
JO - Cureus
DO - 10.7759/cureus.116759
UR - https://europepmc.org/article/MED/42921006
AB - Blunt thoracic aortic injury (BTAI) is uncommon in children and adolescents but carries substantial early mortality. Thoracic endovascular aortic repair (TEVAR) can provide rapid definitive control in anatomically suitable patients; however, the subsequent course is often driven by associated injuries and evolving critical illness. A previously healthy 14-year-old boy was transferred after a high-energy road traffic collision with a contained injury of the descending thoracic aorta, mediastinal hematoma, left femoral and open tibial fractures, pulmonary contusions, and splenic contusion. Emergency TEVAR with a 24 × 80-mm thoracic endograft achieved complete exclusion without endoleak. External fixation of the long-bone fractures followed. After initial extubation, the patient required reintubation on hospital day 4 for severe hypoxemia with bilateral pulmonary consolidations and left pleural effusion; he was successfully extubated two days later. On day 21, delayed ileocecal perforation with diffuse peritonitis required emergency right hemicolectomy. Definitive femoral and tibial intramedullary fixation and pleural drainage were performed on day 35, followed by percutaneous drainage of a pelvic abscess on day 44. He was discharged home neurologically intact on day 50, with a patent, well-positioned endograft and no endoleak. This case shows that successful TEVAR is one component of a prolonged, physiology-driven perioperative strategy requiring continuity across vascular, orthopedic, abdominal, respiratory, and rehabilitation care.
SN - 2168-8184
ER -