[Endovascular treatment of isthmic aortic rupture: use of second generation stent grafts].
OBJECTIVE
Prospective analysis of endovascular management of traumatic isthmic rupture with second generation stent grafts.


METHODS
Prospective analysis and follow-up.


METHODS
Ten consecutive multiple injured patients presenting an acute isthmic traumatic rupture who underwent an endovascular repair with second generation stent grafts.


RESULTS
The aortic injury was diagnosed by spiral computed tomography scan. The appropriate time to repair was decided according to multidisciplinary decision after analysis of associated injuries status and mediastinal lesions evolution. Endovascular repair was successfully completed in all patients under general anaesthesia without requirement of haemodynamic manipulations. Despite a prolonged length of stay related to associated injuries, all patients were discharged from hospital without migration of devices or complication related to the endovascular procedure. After a 20 months follow-up (range 6 - 38 months), all patients were alive with a satisfactory CT scan analysis.


CONCLUSIONS
The immediate availability of the second generation of stents-grafts allowed the endovascular treatment of isthmic rupture without haemodynamic manipulations or massive heparinization. The analysis of this selected series reinforces the interest of this non-invasive technique for anaesthetists especially in polytraumatized patients.
Michelet
P
P
Département d'anesthésie et de réanimation, hôpital Sainte-Marguerite, 13274 Marseille cedex 09, France. pierre.michelet@ap-hm.fr
Roch
A
A
Amabile
P
P
Perrin
G
G
Fulachier
V
V
Piquet
P
P
Auffray
J P
JP
D000328:Adult; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery; D011446:Prospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures