An endovascular treatment of a thoracic aortic injury caused by a misplaced pedicle screw: Case report and review of the literature

作者：Tong, Xiang; Gu, Pengcheng; Yu, Dongsheng; Guo, Fang; Lin, Xiangjin^*

来源：Journal of the Formosan Medical Association, 2015, 114(5): 464-468.

DOI：10.1016/j.jfma.2013.09.014

• iatrogenic thoracic injury
• spinal surgery
• stent graft

Aortic injuries are devastating complications after spinal surgery. We here would like to share our experience with a successful endovascular treatment of an iatrogenic thoracic aortic injury caused by misplaced pedicle screw after spinal surgery. A patient underwent posterior spinal surgery for L1 burst fracture was transferred to our department for instrumentation removal. An iatrogenic thoracic aortic injury at T11 level caused by a pedicle screw was recognized after routine CT scans. Complete screw extraction and instrumentation removal were performed after the placement of a thoracic aortic stent graft covering the injured region. The patient had an uneventful postoperative period and no complications were observed in the 1 and 12-month follow-up by contrast-enhanced CT scans. For the delayed thoracic aortic injuries which usually were usually shown on CT scans as pseudoaneurysm or penetration of the aorta, stent graft implantation would provide a preferred solution with high-effectiveness, low-invasiveness and fewer complications compared with conventional open surgery.

• 出版日期2015-5
• 单位浙江大学