Endovascular Stenting for Traumatic Aortic Injury: An Emerging New Standard of Care

Ann Thorac Surg. 2008 May;85(5):1625-9; discussion 1629-30. doi: 10.1016/j.athoracsur.2008.01.094.

Abstract

Background: Thoracic aortic injury remains a leading cause of death after blunt trauma. Thoracic aortic stents have the potential to treat aortic tears using a less invasive approach. We have accumulated the largest series of patients treated with blunt thoracic aortic injury over a 2-year period.

Methods: From July 2005 to present, 26 patients presenting with blunt aortic injury were treated with thoracic aortic endografting; these patients were retrospectively compared with the prior 26 patients presenting with similar aortic injury who were treated by open surgical repair. A Severity Characterization of Trauma score calculated for each patient predicts mortality based on severity of injury and degree of physiologic derangement on presentation.

Results: Patients treated with endografting had a significantly shorter length of stay, less intraoperative blood loss, decreased 24-hour blood transfusion, and lower incidence of postoperative tracheostomy compared with patients undergoing open repair. Survival in both groups was similar despite a trend toward higher injury severity among patients treated with endografting.

Conclusions: This early experience suggests that aortic endografting may provide a safe and efficient treatment of aortic tears that cardiac surgeons can be successful in employing.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / injuries*
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / mortality
  • Aortic Rupture / therapy
  • Aortography
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Injury Severity Score
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Risk Factors
  • Stents*
  • Survival Analysis
  • Thoracotomy*
  • Tomography, X-Ray Computed
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / therapy*