Images in Anesthesia: Transesophageal echocardiography enhances endovascular stent placement in traumatic trans-section of the thoracic aorta
Can J Anesth Dobson et al.
51: 931
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The image shown is a 2-D, mid-esophageal long axis view of the aorta in the vicinity of a traumatic pseudo-aneurysm. The stent introducer sits just distal to the orifice of the pseudo-aneurysm and there is an angiogram catheter passing into the ascending aorta. An attempt is bein made to pass a J-tip guidewire beyond the pseudo-aneurysm, into the proximal portion of the aorta. This will guide placement of an endograft that will seal off the pseudo-aneurysm. However, the wire is repetitively engaging the pseudo-aneurysm. This is not evident on plain fluoroscopy nor on angiography.