Acute traumatic aortic rupture: early stent-graft repair.
OBJECTIVE
Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture.


METHODS
Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5+/-7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1).


RESULTS
The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively.


CONCLUSIONS
Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakage.
Lachat
M
M
Clinic for Cardiovascular Surgery, Zurich University Hospital, 100 Rämistrasse, Switzerland. mario.lachat@chi.usz.ch
Pfammatter
T
T
Witzke
H
H
Bernard
E
E
Wolfensberger
U
U
Künzli
A
A
Turina
M
M
D000208:Acute Disease; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D015607:Stents; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging