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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2012 Giugno;19(2):109-11
Traumatic aortic rupture: our experience
Pibiri L., De Giudici M. A., Ruiu G., Ganau C., Moro M., Arzedi R., Petruzzo P., Camparini S.
Department of Vascular Surgery, A. O. Brotzu, Cagliari, Italy
Aim. The aim of the present study was to evaluate the results obtained in a single center using the endovascular procedure (TEVAR) in traumatic thoracic aortic rupture.
Methods. Eleven patients, 7 men and 4 women, mean age 42.5 years, presented a traumatic thoracic aortic rupture and 9 of them underwent TEVAR. The diagnosis of traumatic rupture of aorta was based on a spiral angio-CT, which showed aortic isthmus rupture in 10 patients and rupture of the thoracic aorta down to the thoracic-abdominal transition in the remaining case. Ten patients showed a politraumatic condition. In 8 patients the exclusion of the aortic transected tract occurred by the release of a single device while, due to the migration of the prosthesis during the opening phase, in one case the implantation of a second prosthetic segment was necessary.
Results. Operative survival was 100%, while there was one death due to severe bone and cerebral lesions in third postoperative day. No open conversion was required. There was a type 2 endoleak, which solved spontaneously. After TEVAR nor paraplegia nor neurological complications occurred. One year later a patient developed an upper left extremity weakness due to the proximal migration of the device with occlusion of the ostial left subclavian artery which was treated by a carotid subclavian artery bypass.
Conclusion. TEVAR showed to be less invasive, with low rate of mortality and excellent short-term results. The lack of long-term results does not allow us to indicate it as first choice treatment in young subjects.