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Endovascular management of traumatic thoracic aortic transection
Atasha Asmat1, Lenny Tan, Michael George Caleb
1Department of Cardiac, Thoracic & Vascular Surgery, National University Hospital, Singapore. Atasha_ASMAT@nuh.com.sg
Asian Cardiovascular & Thoracic Annals
|November 18, 2009
Summary
Endovascular stenting offers a promising alternative for treating traumatic thoracic aortic transection, especially in patients with multiple injuries. This minimally invasive approach demonstrated no mortality and low morbidity in a small patient cohort.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Vascular Endovascular Therapy
Background:
- Conventional open surgical repair of traumatic thoracic aortic transection carries high morbidity and mortality risks.
- Patients with multiple injuries present unique challenges for traditional surgical interventions.
Purpose of the Study:
- To evaluate the safety and efficacy of endovascular stenting for traumatic thoracic aortic transection.
- To assess the early and midterm outcomes of endovascular repair in a cohort of polytraumatized patients.
Main Methods:
- A retrospective review of 7 patients with traumatic thoracic aortic transection treated with endovascular stenting between 2002 and 2007.
- Data collected included patient demographics, injury patterns, procedural details, intensive care unit stay, operating time, and follow-up outcomes.
- Arterial access was achieved via femoral cut-down, with one patient requiring adjunctive surgery.
Main Results:
- Technical success was achieved in all 7 patients, with no mortality observed.
- The mean intensive care unit stay was 8.6 days, and the mean operating time was 122 minutes.
- One patient experienced a stroke; no procedure-related paralysis occurred. Follow-up showed no endoleaks, stent migration, or pseudoaneurysms.
Conclusions:
- Endovascular stenting is a viable treatment option for traumatic thoracic aortic transection, associated with low morbidity and mortality.
- Early and midterm results are encouraging, suggesting a potentially safer alternative to open surgery.
- Long-term durability of endovascular stenting for this indication requires further investigation.
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