Endovascular repair of thoracic aortic traumatic transections is a safe method in patients with complicated injuries.
OBJECTIVE
Historically thoracic aortic rupture secondary to trauma was treated with cardiopulmonary bypass and open surgery. With the advent of endovascular grafting, physicians have the ability to reconstruct the thoracic aortic transection using a less invasive technique. In this study, we examine our experience with stent graft repair of thoracic transections secondary to trauma.


METHODS
The medical records of patients treated at a level I trauma center from 2005 to 2008 were reviewed. Those patients who had an aortic transection treated with an endograft were identified and evaluated for in-hospital mortality and morbidity and concurrent injuries. Demographics, procedural details, and outcomes were analyzed.


RESULTS
Over a 3-year period, 18 thoracic aortic transections secondary to trauma were identified in patients with a mean age of 43 (range, 16-80). Primary technical success was 100%. None of the patients required explant or open repair during this time period. In-hospital mortality was 2 of 18 (11%); all patients had multiple trauma including long bone fractures. The subclavian artery origin was covered by the stent graft in 9 of the 18 patients. The mean estimated blood loss per procedure was 222 cc. No patient in this series had postoperative paraplegia. Follow-up ranged from 1 to 50 months with an average of 13 months. There have been no late explantation or device failures identified.


CONCLUSIONS
Endovascular repair of traumatic thoracic aortic transections can be performed safely with a relatively low mortality and morbidity and should be the procedure of choice for patients presenting with traumatic thoracic aortic ruptures.
Rahimi
Saum A
SA
The Vascular Group, The Institute for Vascular Health and Disease, Albany Medical College, Albany, NY, USA.
Darling
R Clement
RC
Mehta
Manish
M
Roddy
Sean P
SP
Taggert
John B
JB
Sternbach
Yaron
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D055815:Young Adult