title: Endovascular and open repair for blunt aortic injury, treated in one clinical institution in Brazil: a case series.
abstract: OBJECTIVE
  The objective of this retrospective study is to analyze and compare the results of conventional surgical repair and endovascular treatment of blunt aortic injury over the past 8 years.
  
  
  METHODS
  Twenty-eight patients (25 male; mean age, 35 years) were treated for blunt aortic injury between April 2001 and March 2009 in a university hospital in Brazil. Twenty-six patients were included in the study: five were treated with operative repair (OR) and 21 with endovascular treatment (TEVAR). Two patients were excluded from analysis: one was managed conservatively, and one was treated with endovascular treatment for chronic dissection related to aortic trauma.
  
  
  RESULTS
  Mean age was lower in the OR group than in the endovascular treatment group (17.8 vs. 38 years, P = .003). There was one death in the OR group and four deaths in the endovascular treatment group. Mean follow-up for the overall group was 33.6 months, with 48.7 months (range 8-83 months) for the OR group, and 29.8 months (range 2-91 months) for the TEVAR group. Mean time elapsed from injury to repair was 23.4 hours (range 8-48 h, median 20 h) for the OR group and 30.3 hours (range 2-240 h, median 18 h) for the TEVAR group (P = .374). The duration of surgery was shorter in the endovascular treatment group (142 versus 237 minutes; P = .005). There were no significant differences with respect to the number of postoperative days requiring mechanical ventilation, duration of ICU stay or duration of hospital stay.
  
  
  CONCLUSIONS
  In this retrospective analysis, endovascular treatment was a safe method for repair of blunt aortic trauma, with immediate and midterm results that were comparable to those results obtained with operative repair. No complications from the stent graft were identified during follow-up. Nevertheless, long-term follow-up is necessary to confirm the effectiveness of this treatment.
authors.affiliation: Department of Surgery, Vascular and Endovascular Division, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. igorsincos@gmail.com
authors.forename: Igor Rafael
authors.initials: IR
authors.lastname: Sincos
authors.forename: Ricardo
authors.initials: R
authors.lastname: Aun
authors.forename: Sergio Quilici
authors.initials: SQ
authors.lastname: Belczak
authors.forename: Luciano Dias
authors.initials: LD
authors.lastname: Nascimento
authors.forename: Boulanger
authors.initials: B
authors.lastname: Mioto Netto
authors.forename: Ivan
authors.initials: I
authors.lastname: Casella
authors.forename: Erasmo Simao da
authors.initials: ES
authors.lastname: Silva
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D001938:Brazil; D002648:Child; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000601:surgery*; D055815:Young Adult