Endovascular repair of traumatic thoracic aortic tears

Am J Surg. 2012 Mar;203(3):401-4; discussion 404. doi: 10.1016/j.amjsurg.2011.10.008. Epub 2012 Jan 21.

Abstract

Background: Patients with thoracic aorta injuries (TAI) present a unique challenge. The purpose of this study was to review the outcomes of thoracic endovascular aortic repair (TEVAR) in patients with TAI.

Methods: A retrospective chart review of all patients admitted for TEVAR for trauma was performed.

Results: In a 5-year period, 19 patients (6 women and 13 men; average age, 42 y) were admitted to our trauma center with TAI. Mechanism of injury was a motor vehicle crash in 12 patients, motorcycle crash in 2 patients, automobile-pedestrian accident in 2 patients, 1 fall, 1 crush injury, and 1 stab wound to the back. A thoracic endograft was used in 6 patients and proximal aortic cuffs were used in 13 patients (68%). One patient (5%) died. There were no strokes, myocardial infarctions, paraplegia, or renal failure.

Conclusions: TEVAR for TAI appears to be a safe option for patients with multiple injuries. TEVAR in young patients is still controversial because long-term endograft behavior is unknown.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aorta, Thoracic / injuries*
  • Aorta, Thoracic / surgery
  • Endovascular Procedures*
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Grafting
  • Vascular System Injuries / etiology
  • Vascular System Injuries / surgery*
  • Young Adult