title: Outcome of endovascular treatment of traumatic aortic transection.
abstract: OBJECTIVE
  The purpose of this study was to analyze our experience of thoracic endovascular aortic repair (TEVAR) in patients with traumatic aortic transection.
  
  
  METHODS
  This was a single-center consecutive case series that was conducted at the Uppsala University Hospital, Tertiary Referral Center. There were a total of 17 consecutive patients undergoing TEVAR for traumatic thoracic aortic transection. All patients undergoing TEVAR for aortic transection were registered prospectively and their medical records were reviewed regarding technical details, mechanism of injury, and concomitant injuries. Long-term outcome was analyzed with respect to need for reintervention and survival.
  
  
  RESULTS
  Between 2001 and 2010, 17 patients underwent TEVAR for traumatic aortic injury. Median age was 42 years (range, 18-77 years), and 15 of 17 patients (88%) were men. Fourteen patients had been involved in motor vehicle accidents, two had fallen from heights, and one fell off a bicycle on a slope. In all cases, the aortic injury was located in the proximity of the origin of the left subclavian artery. All patients had concomitant injuries. In all patients, a single stent graft was sufficient to exclude the injured part of the aorta. The median cover length was 120 mm (range, 100-200 mm). In-hospital mortality was 24% (4 of 17 patients). One patient died perioperatively and three postoperatively, two from brain injuries and one from multiorgan failure. After a median follow-up of 36 months (range, 10-98 months), three patients underwent reintervention (18%), each patient only once; one for a type I endoleak, and two for pseudocoarctation secondary to stent graft infolding. Two were treated endovascularly, and one had a stent graft explantation.
  
  
  CONCLUSIONS
  Endovascular repair allows rapid and minimally invasive therapy in patients with traumatic aortic injury with good technical results. The outcome is highly dependent on the severity of other concurrent injuries.
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden. joste@me.com
authors.forename: Johnny
authors.initials: J
authors.lastname: Steuer
authors.forename: Anders
authors.initials: A
authors.lastname: Wanhainen
authors.forename: Stefan
authors.initials: S
authors.lastname: Thelin
authors.forename: Rickard
authors.initials: R
authors.lastname: Nyman
authors.forename: Mats-Ola
authors.initials: MO
authors.lastname: Eriksson
authors.forename: Martin
authors.initials: M
authors.lastname: Björck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries*; D001019:Aortic Rupture / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D015331:Cohort Studies; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult