Endovascular repair of thoracic aorta injury: 17 years of single-center experience

Abstract

Background: Traumatic thoracic aortic transection is one of the most severe complications of high-energy injuries, but pa-tients rarely receive treatment, and it is fatal in the vast majority of cases. Due to the complexity of surgical revision for transection, endovascular repair with stent graft implantation is the preferred approach.

Material/Methods: We retrospectively analyzed the short-term and long-term treatment results for 31 patients (29 men, 2 wom-en) treated at the Interventional Radiology Department, University Hospital Ostrava, for the isthmus part of a descending thoracic aorta injury between 2004 and 2020.

Results: The median patient age was 48 years (interquartile range [IQR]: 28-63 years). The most common causes of in-jury were traffic accidents and falls or jumps, with the trauma location at the Ishimaru zones 2 to 4 of the aor-tic isthmus. Aortic stent grafts were successfully implanted in all patients; 13% of patients had complications and 10% died due to the trauma severity. The median procedure duration was 30 min (IQR: 25-43 min) and the median hospital stay was 29 days (IQR: 28-63 days).

Conclusions: Aortic stent graft implantation appears to be a safe and effective method for dealing with thoracic aorta inju-ry, with a low complication rate and high patient survival. The endovascular approach is the method of choice for treating this severe disease, and a multidisciplinary approach for emergency medical treatment with a com-prehensive trauma protocol is essential.