We present a clinical case of successful endovascular treatment of a patient with traumatic injury to the thoracic aorta as a result of a shrapnel wound. Our report emphasises the importance of timely diagnosis and proper management of patients in such cases, as well as the significance of specialised interventions in patients with aortic injuries.

Aortic injuries are particularly critical due to the high risk and subsequent massive blood loss. Combined trauma exacerbates the patient's general condition and significantly increases the risk of complications and fatal outcomes, which further complicates the results of open surgery.

In our clinical observation, a patient with a fragmentary injury to the thoracic aorta developed an arteriovenous fistula and aortic aneurysms. A two-stage endovascular treatment was performed on the patient, the first stage being the implantation of a stent graft in the AOS, and the second stage being the embolisation of the thoracic aortic aneurysm cavity with a microcoil.

In our clinical case, imaging methods such as computed tomography and angiography were used for diagnosis and treatment decision-making. It is worth noting the effectiveness and low trauma of endovascular treatment methods, which lead to better treatment results, despite certain limitations and risks associated with endovascular stent graft implantation in the treatment of post-traumatic arteriovenous fistulas and aortic aneurysms.

Endovascular techniques for injuries to major vessels have repeatedly proven their effectiveness and safety with proper computer diagnostics and appropriate selection of instruments. Such interventions make it possible to break the «vicious circle» of arteriovenous fistulas, eliminate the danger of pseudoaneurysms, restore major blood flow, or stop bleeding. Endovascular treatment is an excellent alternative to «open» surgery, as it increasingly strives for low trauma, greater precision, and even outpatient treatment. A series of observations and unusual and non-standard clinical cases described in the literature only prove the flexibility and value of treatment methods that are sometimes unproven in randomised studies.

In 2024, he graduated from the Russian University of Medicine (ROSUNIMED). Since 2024, he has been working at the cardiology centre of the FSBI «NMRC of HMT named after A.A. Vishnevsky» Russian Ministry of Defence. Since 2025, he has been a member of the Department of X-ray Endovascular Diagnostics and Treatment at the Medical Institute of Continuing Education of the Russian Biotechnological University (ROSBIOTECH) at the FSBI «NMRC of HMT named after A.A. Vishnevsky» Russian Ministry of Defense. Proficient in angiography and X-ray surgical techniques, including angioplasty of coronary, brachiocephalic, renal and peripheral arteries, and endovascular aortic prosthetics. Regular participant in Russian and international conferences. Author of scientific papers on cardiology and endovascular surgery.