Emergency endovascular treatment of thoracic aortic rupture in three accident victims with multiple injuries.
OBJECTIVE
To report an experience with emergency endovascular treatment of traumatic thoracic aortic ruptures in multi-injured patients.


METHODS
Three victims of motor vehicle accidents with multiple head, chest, and abdominal injuries in addition to fractures were treated urgently for thoracic aortic lacerations with transluminal placement of an endovascular graft during the initial emergent laparotomy. In all cases, ruptured visceral organs were treated first and the abdomen closed. Femoral artery access was gained through a cutdown, and the endografts were delivered with no systemic heparinization. The endovascular component of the surgical session took approximately 50 minutes. All patients survived to discharge. Two patients are alive at 5 and 12 months with sustained endovascular exclusion of the pseudoaneurysm, but one patient with severe brain damage died 9 months after treatment from respiratory insufficiency.


CONCLUSIONS
Acute endovascular treatment of thoracic aortic ruptures is feasible and has the advantage of avoiding thoracotomy in otherwise severely injured patients.
Nio
Denise
D
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Vos
Patrick M
PM
de Mol
Bas A J M
BA
Ponsen
Kees J
KJ
Reekers
Jim A
JA
Balm
Ron
R
D000063:Accidents, Traffic; D000328:Adult; D015901:Angiography, Digital Subtraction; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004630:Emergencies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000150:complications