Revista chilena de cirugía
versión On-line ISSN 0718-4026
MARINE M, LEOPOLDO et al. Endovascular treatment of acute traumatic aortic rupture. Rev Chil Cir [online]. 2011, vol.63, n.1, pp. 21-27. ISSN 0718-4026. doi: 10.4067/S0718-40262011000100004.
Background: Traumatic rupture of the thoracic aorta as a result from high-speed deceleration injury is associated with a mortality rate of 80% to 90% at the scene of the accident. Survivors usually have life-threatening injuries to other organ systems. Standard open repair is associated with a high penoperative morbidity and mortality. Endografting offers a less invasive alternative to open surgical repair. Aim: To evaluate results of endovascular management of acute traumatic descending thoracic aortic ruptures. Methods: Between August 2002 and March 2010, patients treated for this trauma were reviewed. Results: 16 patients (fourteen males mean age 42.7 ± 15.8 years, range 24-74) underwent endovascular treatment of an acute aortic rupture. Associated traumas in fifteen patients were: severe brain (7), spleen (4), liver (1), kidney (3) and large bone (9) injuries. Motor vehicle accidents caused 13 of the injuries and fall from height 3. Rupture was diagnosed with admission CT sean and confirmed by intraoperative angiogram. Patients were treated with thoracic aortic endograft, in 11 cases the left subclavian artery was covered with no need for further revascularization. Technical success was 100%, no procedure-related mortality or paraplegia was observed. One patient died 5 days after the procedure due to severe associated injuries. During a mean follow-up of 30.8 months (range 1-80), no deaths, complications or need for further interventions presented. Conclusion: Endovascular treatment of acute traumatic aortic isthmic rupture is encouraging and compares favorably to open surgical approach with low morbidity and mortality rates.
Palabras clave : Thoracic aorta; traumatic rupture; endovascular; endograft.