Management of thoracic vascular injury predominantly focuses on the aorta and its tributaries while reports of venous injury are less frequent. Although rare, traumatic azygous vein injuries are associated with high mortality. Prompt treatment is required and has traditionally been open surgery. We present a case of an endovascular repair of an azygous vein injury. A female patient presented to our trauma center following ejection after a motor vehicle collision (MVC). CT imaging workup revealed mediastinal and periaortic hematoma with active contrast extravasation adjacent to the azygos vein. She was referred to interventional radiology for vascular evaluation and potential endovascular intervention. The patient met criteria for class III hypovolemic shock upon arrival in the endovascular suite. Aortography demonstrated no arterial injury. Venography revealed a pseudoaneurysm on the superior aspect of the azygos arch and contrast extravasation from the inferior margin of the azygous arch. A stent-graft was deployed and post-deployment venogram showed no extravasation and successful exclusion of the injuries. The patient did not have further signs of bleeding. She left the interventional suite with improved vital signs, yet her condition remained guarded. Follow-up CT chest confirmed continued patency of the stent-graft at 8 days and 2 years post-procedure. Historically, azygos vein injuries are a rare occurrence and managed with open surgery. Swift management is necessary to prevent the increased morbidity and mortality associated with azygous vein injury, particularly in polytrauma patients such as the one presented here. We believe endovascular stent-graft treatment offers an innovative alternative to the current standard of operative management of azygos vein injury.

中文翻译：

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外伤性奇静脉损伤的腔内治疗：1例报告

胸腔血管损伤的处理主要集中在主动脉及其分支，而静脉损伤的报告较少。虽然罕见，但外伤性奇静脉损伤与高死亡率有关。需要及时治疗，传统上是开放手术。我们介绍了一个奇静脉损伤的血管内修复案例。一名女性患者在机动车辆碰撞 (MVC) 后被弹射到我们的创伤中心。CT 成像检查显示纵隔和主动脉周围血肿，在奇静脉附近有活跃的对比剂外渗。她被转诊到介入放射科进行血管评估和潜在的血管内介入治疗。患者到达血管内套件时符合 III 级低血容量性休克的标准。主动脉造影显示没有动脉损伤。静脉造影显示奇弓上方有假性动脉瘤，奇弓下缘有造影剂外渗。支架移植物被部署并且部署后静脉造影显示没有外渗并且成功排除了损伤。患者没有进一步的出血迹象。她离开介入治疗室时生命体征有所改善，但她的病情仍然受到保护。随访 CT 胸部证实了支架移植物在术后 8 天和 2 年的持续通畅。从历史上看，奇静脉损伤很少发生，可以通过开放手术进行治疗。快速管理对于防止与奇静脉损伤相关的发病率和死亡率增加是必要的，特别是在多发伤患者中，例如此处介绍的患者。