Traumatic Aortic Injury: Clinical Results of Endovascular Repair, 5-Year Experiences in a Single Regional Trauma Center

Objectives: Traumatic aortic injury (TAI) is rare but is highly fatal. In determining how to treat TAI, there are many factors to consider, due to the complexity of concomitant traumatic injuries. The European Society of Cardiology recommends that thoracic endovascular aortic repair (TEVAR) should be preferred to open surgical repair in cases of TAI with suitable anatomy. We evaluated the clinical efficacy and safety of TEVAR for the treatment of TAI in a regional trauma center. Methods: A retrospective electronic medical record review of all patients undergoing TEVAR for TAI between November 2014 and September 2019 at a Korean Regional Trauma Care Center was performed. Reviewed results included patient demographics, initial and follow-up computed tomographic scan results, angiographic findings, TAI type and sites, time from injury to repair, injury severity score, and clinical outcomes including survival duration and procedure-related complications. Results: Twenty-three trauma patients from a single trauma care center underwent TEVAR. The mean age was 54 years and 18 patients were male. The proximal landing zone involved was aortic arch zone 2 in 43.4% and zones 3 and 4 in 56.6% of procedures. Technical success was achieved in all cases. No patient developed procedure-related paraplegia or required conversion to open surgery. Follow-up imaging demonstrated complete exclusion of the traumatic tear and regression of the false aneurysms without endoleak or stent-graft-induced new entry or symptom of steal syndrome during follow-up duration 332.0 ± 285.0 (15–03 days). Thirty-day mortality was 8.7% (n = 2). Conclusion: TEVAR is a reliable, safe, convenient with less complications for TAI, especially given the consideration in cases with suitable aortic anatomy and appropriate hemodynamic status.

Publication History

Article published online:
26 April 2021