Early outcome of endovascular treatment of acute traumatic aortic injuries: the talent thoracic retrospective registry.
BACKGROUND
Acute traumatic injury of the thoracic aorta (TAI) is a life-threatening complication in patients who sustain deceleration or crush injuries. This study was conducted to examine the results in patients who underwent endovascular repair with the Talent (Medtronic/AVE, Santa Rosa, CA) thoracic stent graft for acute traumatic injury.


METHODS
Out of 457 consecutive endograft patients, 41 (9%) were treated for traumatic aortic conditions. There were 36 males with a mean age of 36 +/- 14 years. Mean aortic diameter at the time of intervention was 34 mm +/- 9 (range, 20 to 70 mm). The mean length of covered aorta was 106 mm (range, 5 to 130 mm) with only one stent graft used in 98% (40) of all cases. Median follow-up period for hospital survivors was 13 months (1.0 to 69.0 months).


RESULTS
Stent graft implantation was technically successful in all cases (100%). One patient died during hospitalization, yielding an overall in-hospital mortality rate of 2.4%. Procedural-related paraplegia was zero and a primary endoleak was observed in 1 patient. Postoperative complications occurred in 4 patients (3 respiratory failures, 1 multiorgan failure). No patient required conversion to open surgical repair.


CONCLUSIONS
The treatment of acute traumatic injuries of the descending thoracic aorta with the Talent stent graft is a feasible and safe technique; it provides low morbidity and mortality rates in the early postoperative period, and early results are encouraging. However, long-term studies are worthwhile to evaluate the effectiveness and the durability of this procedure.
Ehrlich
Marek P
MP
Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria. marek.ehrlich@meduniwien.ac.at
Rousseau
Hervé
H
Heijman
Robin
R
Piquet
Philippe
P
Beregi
Jean-Paul
JP
Nienaber
Christoph A
CA
Sodeck
Gottfried
G
Fattori
Rossella
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000293:injuries*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult