Endovascular treatment of aortic rupture by blunt chest trauma

Background The usual treatment of blunt aortic injury (BAI) is prompt surge ry, Frequently severe injuries to the brain or lungs exclude further surgic al treatment. The purpose of this study is to assess the feasibility of pla cing endovascular stent-grafts. Methods. From 1992 through 1999, in our primary and referral trauma center, 26 acute BAI, 21 males and 5 females, mean age 40.2 +/- 16.3 yrs were diag nosed. The last 4 patients underwent prospectively endovascular repair with Talent endograft. Endoprosthesis parameters were measured on three-dimensi onal spiral CT reconstruction, While waiting for devices, blood pressure wa s aggressively lowered and aortic lesions were monitored by transesophageal echography, Results, Stent-graft deployment was successful in all 4 patients. There wer e no complications of endoleak, stent migration, paraplegia or death Angiog raphic exclusion was complete in all 4 patients. CT scans at a mean followu p of 11 +/-5 months showed complete healing of the aortic wall in all patie nts. Conclusions, For stable acute BAI, endovascular stent-graft repair is feasi ble and safe, and is an effective therapeutic alternative to open surgery. Because of the normal proximal and distal wall in aortic injuries, endolumi nal treatment might be the therapy of choice in the near future.