title: Outcomes of endovascular repair for blunt thoracic aortic injury.
abstract: OBJECTIVE
  Consistent long-term follow-up data of thoracic endovascular repair (TEVAR) for acute blunt thoracic aortic injury (BTAI) are largely absent at this time. The late outcomes of TEVAR for BTAI are the focus of this study to evaluate the durability of this type of repair.
  
  
  METHODS
  The records of 46 consecutive cases of TEVAR for BTAI from November 2000 to August 2012 were reviewed. Patient demographics, lesion characteristics, procedure details, and outcomes were recorded. We performed a clinical and body computed tomography angiography follow-up at 1, 6, and 12 months after the intervention; thereafter, it was done on a yearly basis if device-related defects were ruled out.
  
  
  RESULTS
  There were 35 (76.1%) males. Mean age was 39 ± 18 years (range, 17-92). Indications for intervention were BTAI at the aortic isthmus in 73.9% (n = 34) of the cases, and in the proximal one-half of the descending thoracic aorta in the remaining 26.1% (n = 12). Pseudoaneurysm or free rupture accounted for 44 (95.6%) cases. Primary technical success was obtained in all cases. All patients survived the intervention, open conversion was never required, and no patient required reintervention. In-hospital mortality was 6.5% (n = 3). Mean follow-up was 66 ± 46 months (range, 1-144; median, 72). No patient was lost during this period. All patients who were discharged from the hospital are still alive. Aortic hematoma or hemothorax were completely reabsorbed in 42 (97.7%) cases. Endoleak or modifications of the native aorta were never detected; endograft-related complication was observed in one (2.3%) case only. An asymptomatic collapse was observed at a 36-month follow-up and was managed conservatively.
  
  
  CONCLUSIONS
  Midterm follow-up of TEVAR for acute BTAI is feasible with satisfactory late outcomes. In our experience, TEVAR is a durable and definitive treatment for BTAI.
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy. Electronic address: gabriele.piffaretti@uninsubria.it.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.forename: Filippo
authors.initials: F
authors.lastname: Benedetto
authors.forename: Mirko
authors.initials: M
authors.lastname: Menegolo
authors.forename: Michele
authors.initials: M
authors.lastname: Antonello
authors.forename: Antonino
authors.initials: A
authors.lastname: Tarallo
authors.forename: Franco
authors.initials: F
authors.lastname: Grego
authors.forename: Francesco
authors.initials: F
authors.lastname: Spinelli
authors.forename: Patrizio
authors.initials: P
authors.lastname: Castelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D055815:Young Adult