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Stent-graft repair for blunt traumatic aortic injury: functional and survival outcomes
S González Sánchez1, A Martín Conejero, G Moñux Ducajú
1Service of Angiology and Vascular Surgery, San Carlos Clinical Hospital, Madrid, Spain. saragonzalezsanchez@gmail.com
Aim:
Traumatic aortic injury is usually lethal, most often because of serious associated wounds. The short- and midterm outcome of endovascular exclusion was assessed as the current treatment of choice due to a lower mortality and morbidity than open surgical treatment.
Methods:
We reviewed the cases of 8 patients (5 male, mean age 33 years) undergoing endovascular repair of a traumatic thoracic aortic lesion, confirmed by computed tomographic angiography, at our centre. Most patients showed a contained lesion limited to the aortic isthmus and severe associated injuries.
Results:
Intrahospital mortality was 37.5% (N.=3) and mostly due to posttraumatic brain injury (N.=2). Most patients were hemodynamically stable at the time of endovascular repair (N.=6). The median time to surgery was 12 hours (3-48 hours). The endografts used were TAG® (W.L. Gore and Associates, Flagstaff) in three patients, and Valiant® (Medtronic, Santa Rosa, CA) in four. The technical success rate was 100%. In one case, the left subclavian artery was occluded without signs of arm ischemia. There were no cases of paraplegia or stroke related to treatment. No revision procedures were needed during follow-up.
Conclusion:
Endovascular repair shortly after injury seems to be effective and safe with a low associated morbidity and mortality.
