Effectiveness of Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Ann Thorac Cardiovasc Surg. 2023 Jun 20;29(3):133-140. doi: 10.5761/atcs.oa.22-00095. Epub 2022 Dec 28.

Abstract

Purpose: Blunt thoracic aortic injury (BTAI) has a high mortality rate, and the occurrence of clinical complications is high. Several studies have reported the efficacy of thoracic endovascular aortic repair (TEVAR) for BTAI. This study aimed to clarify the use of TEVAR for BTAI.

Methods: We analyzed 10 cases of TEVAR for BTAI from July 2011 to December 2020 at our hospital. Five of 10 cases of BTAI were caused by road traffic accidents, while five were caused by falls from a height.

Results: The mean patient age was 59.3 years. When arriving at our hospital, seven of 10 patients were in shock. Nine of 10 cases of BTAI were at the aortic isthmus. With respect to BTAI severity, five of 10 patients were categorized as grade IV. Ps of non-survivors were extremely low. All patients underwent TEVAR. The mean surgical duration and volume of intraoperative blood loss were 77.5 minutes and 234 ml, respectively.

Conclusion: The results of TEVAR for BTAI at our institution support previous reports, which show excellent clinical results. To further improve the outcomes, we must clarify the adaptation of nonoperative management (delayed repair), the optimal timing of invasive treatment, and the importance of long-term follow-up.

Keywords: BTAI; TEVAR; durable treatment.

MeSH terms

  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Endovascular Aneurysm Repair
  • Endovascular Procedures*
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Thoracic Injuries* / diagnostic imaging
  • Thoracic Injuries* / surgery
  • Time Factors
  • Treatment Outcome
  • Vascular System Injuries* / diagnostic imaging
  • Vascular System Injuries* / etiology
  • Vascular System Injuries* / surgery
  • Wounds, Nonpenetrating* / diagnostic imaging
  • Wounds, Nonpenetrating* / surgery