Endovascular repair of traumatic thoracic aortic injury:10-year single-center experience

摘要

Background Traumatic thoracic aortic injury(TAI) is an uncommon but fatal injury. The purpose of this study was to present our experience and results of thoracic endovascular aortic repair(TEVAR) in patients with TAI in single center. Methods From February 2007 to March 2016, the medical records of 21 patients with TAI admitted to our institution were retrospectively reviewed. Among these patients, 20 patients were treated with TEVAR and 1 was excluded for posterolateral thoracotomy. The demographics, injury characteristics, procedural details, and clinical outcomes of these patients were evaluated. Results In the 20 patients with TEVAR, 14 patients were man(70.0%) and the mean age was 34.3±10.8 years(range, 14-55 years). The causes of injury were motor vehicle accident(18/20, 90.0%) and fall from height( 2/20, 10.0%). All patients had concomitant injuries and a mean ISS was 36.0 ± 15.0(20-75). All patients received TEVAR with the aortic injuries located at aortic isthmus(11/20, 55.0%) and the remaining at descending aorta. Nine patients received intentional coverage of LSA during TEVAR. Of which, 6 cases were partial coverage. The primary technical success of TEVAR was100% and a single stent graft was sufficed for the TAI repair in all cases. The average cover length was 152.3 ±20.0 mm(range, 100-200 mm). No patient died or had serious postoperative complications in hospital. The rate of absorption period of aortic injuries after TEVAR for ≤3 months, 3-6 months, and ≥6 months was 65.0%,30.0%, and 5.0% respectively. There was no late explanation or device failures identified although 2 patients were detected poor apposition in the 12 months after TEVAR. Conclusions TEVAR can be performed safely with a relatively low mortality and morbidity and should be the preferred treatment for patients with TAI. But the durability of endograft needs long follow-up.