Successful treatment and survival after gunshot wound to the aortic arch with bullet embolism to superficial femoral artery

Mortality after gunshot wounds to the thoracic aorta ranges from 92% to 100%. Survival is almost always in patients with injury from low-caliber, low-velocity bullets with hemorrhage contained by the wall of the aorta. Bullet embolization, even rarer with a reported incidence of 0.3% of vascular injuries, is most commonly found during autopsy. We report the successful treatment and survival of a patient who presented with a large-caliber gunshot wound to the aortic arch with contained rupture and bullet embolization from the aortic arch to the superficial femoral artery. The patient remained functionally independent and was discharged without complication.