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KMID : 0882420120830020202
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Korean Journal of Medicine
2012 Volume.83 No. 2 p.202 ~ p.209
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Mid-Term Results of Endovascular Repair for Traumatic Aortic Injury
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Kim Seon-Hee
Song Seung-Hwan
Kim Sang-Pil
Lee Choong-Won
Choi Jeong-Cheon
Ahn Jin-Hee
Lee Han-Cheol
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Abstract
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Background/Aims: Traumatic aortic injury (TAI) is rarely seen clinically, but is highly fatal. In determining how to treat TAI, there are many factors to consider, due to the complexity of concomitant injuries. The Society of Vascular Surgery recommends that thoracic endovascular aortic repair (TEVAR) should be preferentially performed over open surgical repair. We evaluated the efficacy of TEVAR based on our experiences in TAI treatment.
Methods: Between July 2008 and August 2011, we conducted a retrospective analysis of the patients who underwent TEVAR following TAI and analyzed factors including TAI type and sites, time from injury to repair, Injury Severity Score, and complications. Seven patients with multiple injuries underwent TEVAR in the acute setting. Follow-up was accomplished regularly by computed tomographic angiography (CTA).
Results: Type III aortic injury, rib fractures, and hemothorax were found in all patients. TEVAR was successfully performed. Completion angiography demonstrated complete exclusion of pseudoaneurysm without endoleakage, and perfusion of aortic arch vessels was maintained. There was no in-hospital mortality or evidence of spinal cord ischemia. The average follow-up duration was 30.4 ± 23.9 months, and regular CTA revealed good durability of the stent-graft without late complications such as endoleakage, stent migration, or pseudoaneurysm formation.
Conclusions: Through this study, we were able to identify good mid-term results of TEVAR in our hospital. TEVAR is thought to be a good modality with which to treat acute traumatic aortic injury, especially given the consideration of bleeding risk in trauma patients with multiple injuries.
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KEYWORD
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Multiple trauma, Endovascular procedures, Thoracic aortic aneurysm, Thoracic injuries, Stents
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