Endovascular treatment of traumatic rupture of the thoracic aorta

Abstract

Endovascular repair of traumatic rupture of the thoracic aorta seems to reduce morbidity and mortality in patients with multiple trauma. Ideally, both devices and experienced personnel should be available in trauma centres.

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease

“…Although endovascular stent grafting has not been prospectively studied for this clinical scenario, US Food and Drug Administration-approved devices are being used "off label," with considerable success reported based on retrospective studies. In a collected series of 284 patients reported in the literature, Lettinga-van de Poll and colleagues reported the procedure-related mortality was 1.5%, 6.7% had endoleaks, and 14.4% had procedure-related complications (358,(365)(366)(367)(368)(369)(370). In a multicenter study of 30 patients with 100% implantation success, 6% to 7% of patients died, 1 had a stroke (3.3%), and 1 had partial stent collapse (3.3%) (370).…”

Endovascular stenting versus open surgery for thoracic aortic disease: Systematic review and meta-analysis of perioperative results

“…9 Endovascular management of aortic trauma is associated with a 1.5% perioperative mortality and a 14% morbidity rate. 10 Open surgery may achieve similar perioperative mortality results. 11 Neither meta-analysis published to date included a comparison with the results of open surgery.…”

Combined left ventricle and descending aorta gunshot wound

“…Recently we stated endovascular treatment to be a safe and efficient therapeutic option in blunt thoracic aortic trauma [33]. Several other series also showed endovascular treatment to be an efficient therapeutic option with good short-and midterm results [2,11,[7][8][9][15][16][17][19][20][21][22][23][24][25]27,36,28,32,1]. We consider interventional radiology and stent graft placement as therapeutic option for penetrating aortic trauma.…”