2018 Volume 32 Issue 4 Pages 422-425
A 54-year-old woman was struck from behind while driving. Her vital signs were stable on admission to the first hospital, but chest CT demonstrated hematoma surrounding the brachiocephalic artery, in addition to facial bone and pelvic fractures. She was transported to our hospital and an emergency operation was performed. The tunica intima was disrupted at a proximal portion of the brachiocephalic artery, and an aneurysm had formed. An extracorporeal circuit was created from the ascending aorta to the right common carotid artery using a temporary shunt tube, and artificial vessel replacement of the brachiocephalic artery was safely performed while clamping the right common carotid artery and the right subclavian artery. The patient was discharged without any neurological deficit. The surgical strategy of revascularizing while maintaining cerebral perfusion employed in this case is useful for traumatic injury to the brachiocephalic artery with poor collaterals.
