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Dissection of the abdominal aorta in blunt trauma: management by percutaneous stent placement
H Vernhet1, C H Marty-Ané, A Lesnik
1Department of Thoracic and Cardiovascular Imaging, CHU Arnaud de Villeneuve, F-34295 Montpellier cedex, France.
Insights
Stent placement effectively treated traumatic aortic dissections in three patients, resolving false channel circulation and preventing complications. This minimally invasive approach offers a promising solution for non-iatrogenic aortic dissections.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Traumatic aortic dissections can lead to limb ischemia and complex anatomical challenges.
- Endovascular repair using stents is an emerging option for managing aortic pathologies.
Observation:
- Three patients with traumatic abdominal aortic dissections underwent stent implantation.
- Dissections involved false channel extension to iliac arteries, with one case complicated by right limb ischemia.
- Diagnostic imaging included ultrasound, CT, and arteriography for diagnosis and follow-up.
Findings:
- Successful occlusion of the false channel was achieved in all patients.
- No significant residual stenosis or early/late complications were observed.
- Follow-up extended up to 2 years post-intervention.
Implications:
- Stent placement demonstrates efficacy in treating non-iatrogenic inframesenteric aortic dissections.
- This endovascular technique offers a safe and effective alternative to open surgical repair.
- Further research can explore long-term outcomes and broader applications of stent-graft technology in aortic trauma.
Abstract:
We implanted stents in three patients who had traumatic abdominal aortic dissections, complicated by right limb ischemia in one case. The circulating false channel extended to the left iliac artery in one case and to both iliac arteries in the last case. Diagnosis and radiological follow-up included ultrasound, computed tomography, and arteriography. Two patients were treated with Wallstents, one with a Palmaz stent. The occlusion of the false channel was obtained in all patients without any significant residual stenosis. No early or late complication was noted in any of the patients. The longest follow-up was 2 years. We conclude that stent placement is an efficient method for the treatment of noniatrogenic inframesenteric aortic dissections.