ase report C Seat belt aorta, an underdiagnosed cause of young adult aortic thrombosis. Case report José Tiago, Viviana Manuel, Sónia Ribeiro, Carlos Martins, Luis Pedro, José Fernandes e Fernandes Vascular Surgery Department, Hospital Santa Maria, Lisboa, Portugal
Safety belts were created to protect lives in accidents, however every year thousands of lives are lost in car crashes. Different modalities of blunt trauma may occur during accidents and steering wheel and seat belt injuries are common. Although seat belts are known to cause injuries to the abdominal viscera, they rarely produce aortic trauma, and when occurs mainly involves the thoracic aorta while the abdominal aorta is frequently spared. Seat belt aortic thrombosis results from direct compression of the aorta between the horizontal part of the seat belt and the vertebrae, resulting in intimal dissection. It is an infrequent event and represents only 0.04% of all blunt abdominal trauma. We report a 23 year old female that was admitted to our department 2 years after a major car crash accident with complaints of critical limb ischemia. The physical examination shows no palpable pulses in the limbs and CT scan revealed an infra-renal aortic partial occlusion. The patient was treated percutaneously with Advanta V12 stent graft deployed in the infrarenal aorta. One year after the procedure, she is performing well with all palpable pulses and no complaints. CT scan reveals a well deployed graft with no signs of aortic thrombosis. Seat belt aorta is a rare potential lethal lesion, can be asymptomatic in the initial phase and may evolute to chronicity causing critical limb ischaemia. Understanding the mechanisms of safety belt compression over the infrarenal aorta and being alert for clinical signs allow for prompt recognition even in the chronic phase. Nowadays endovascular treatment with stents or stent grafts is feasible percutaneously and can be the first option of treatment in the acute or chronic phase.
Left foot, ischaemic toe
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