Although traumatic rupture of the thoracic aorta has been considered a surgical emergency, we report here an example of successful delayed surgery for acute traumatic rupture of the aortic arch with an isolated left vertebral artery in an 18-year-old woman. The patient was.admitted to the intensive care unit with hemothorax and, rib fractures, and a decision was made to treat the aortic injury conservatively until the patient was stabilized. She underwent surgery after 3 months of observation. After the isolated left vertebral artery had been anastomosed to the left carotid artery, total arch replacement was performed. Delayed surgery for aortic rupture as a treatment choice may be of benefit in selected cases of complex trauma.

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