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Thoracic aorta endoprosthesis: the final countdown for open surgery after traumatic aortic rupture?
G Daenen1, G Maleux, K Daenens
1Centre Vascular Diseases, University Hospital Gasthuisberg, Leuven, Belgium.
Annals of Vascular Surgery
|March 5, 2003
Summary
Endovascular stent graft repair is a feasible and safe alternative for thoracic aortic isthmus rupture. This minimally invasive approach offers potential benefits over open surgery for patients with this critical vascular condition.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Thoracic Surgery
Background:
- Thoracic aortic isthmus rupture presents a significant surgical challenge.
- Traditional open surgical repair is associated with high mortality and morbidity.
- Endovascular techniques offer a less invasive alternative for complex aortic pathologies.
Purpose of the Study:
- To evaluate the feasibility and safety of endovascular stent graft repair for thoracic aortic isthmus rupture.
- To assess the outcomes of urgent endovascular repair in patients with aortic isthmic rupture.
- To compare endovascular repair with open surgery for this condition.
Main Methods:
- Seven patients with thoracic aortic isthmus rupture underwent endovascular stent graft repair.
- Diagnosis confirmed by chest X-ray, transesophageal echocardiography, CT scan, and aortography.
- Blood pressure management and close monitoring during the pre-operative delay period.
Main Results:
- Complete exclusion of the pseudoaneurysmal sac was achieved in all patients.
- No patients experienced arm ischemia or claudication despite subclavian artery coverage in two cases.
- One peri-procedural death occurred due to underlying comorbidities and associated injuries.
Conclusions:
- Endovascular stent grafting is technically feasible for thoracic aortic isthmus rupture.
- It represents a safe and potentially valuable alternative to open surgery.
- Further long-term follow-up is necessary to fully assess its therapeutic potential.