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TEVAR has revolutionized the treatment of traumatic aortic injury (TAI) by decreasing the procedural mortality and subsequent morbidities. Although the immediate procedural result was excellent, mid and longterm success might be compromised by important complications. Device collapse, endoleak, cerebrovascular accident and to a lesser degree, spinal cord injuries, have all been reported after TEVAR. In this report we will focused on post-TEVAR iatrogenic coarctation (PTIC), which can have silent presentation but important consequences.
Aortic coarctation might be observed in three form during the management of TAI. The first form which is known as pseuodcoarctation syndrome, is defined as diminished lower limb pulses with normal/elevated upper limb pulses accompanied sometimes by systolic murmur heard over back thoracic between the scapulae. Aortic tear obstructs the intraluminal space, creating the coarctation-like lesion. Observed in 10% of TAI patients, it was used as a sign to suspect aortic injury in multiple trauma patients before the widespread use of imaging, and also considered as marker of severity of the pathology, which necessitate acute treatment.