Traumatic pseudoaneurysm of the thoracic aorta in close proximity to the anterior spinal artery: A therapeutic dilemma

Operative therapy is generally advocated for the management of chronic traumatic pseudoaneurysms of the aorta. A potential complication of both thoracic and abdominal aortic aneurysmectomies is paraplegia secondary to infarction or ischemia of the spinal cord. The present report describes a patient with a traumatic aneurysm of the lower thoracic aorta immediately adjacent to the origin of the anterior spinal artery, both delineated angiographically. In this particular situation, it was elected to follow the patient because the aneurysm was asymptomatic, small, and chronic, and because the risk of spinal cord injury associated with aneurysmectomy was estimated to be high. Serial computerized tomography (CT) scanning was used as a means of measuring the exact aneurysm size. Operation will be recommended if the aneurysm produces symptoms or enlarges, as demonstrated by CT scans.