Endovascular stenting for traumatic aortic injury: an emerging new standard of care.
BACKGROUND
Thoracic aortic injury remains a leading cause of death after blunt trauma. Thoracic aortic stents have the potential to treat aortic tears using a less invasive approach. We have accumulated the largest series of patients treated with blunt thoracic aortic injury over a 2-year period.


METHODS
From July 2005 to present, 26 patients presenting with blunt aortic injury were treated with thoracic aortic endografting; these patients were retrospectively compared with the prior 26 patients presenting with similar aortic injury who were treated by open surgical repair. A Severity Characterization of Trauma score calculated for each patient predicts mortality based on severity of injury and degree of physiologic derangement on presentation.


RESULTS
Patients treated with endografting had a significantly shorter length of stay, less intraoperative blood loss, decreased 24-hour blood transfusion, and lower incidence of postoperative tracheostomy compared with patients undergoing open repair. Survival in both groups was similar despite a trend toward higher injury severity among patients treated with endografting.


CONCLUSIONS
This early experience suggests that aortic endografting may provide a safe and efficient treatment of aortic tears that cardiac surgeons can be successful in employing.
Moainie
Sina L
SL
Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. smoainie@smail.umaryland.edu
Neschis
David G
DG
Gammie
James S
JS
Brown
James M
JM
Poston
Robert S
RS
Scalea
Thomas M
TM
Griffith
Bartley P
BP
D000293:Adolescent; D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D001027:Aortography; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012307:Risk Factors; D015607:Stents; D016019:Survival Analysis; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*