Endovascular Repair of Blunt Thoracic Aortic Injury Using the Gore Thoracic Aortic Graft (TAG): A Single Center Experience.

Objectives: Endovascular treatment of thoracic aortic injury (TAI) is an alternative to open repair in patients with blunt trauma. We report our initial experience using the TAG device (W.L. Gore, Flagstaff, AZ).
Methods: Between September of 2005 and August 2006, eight patients with TAI underwent endovascular repair using the TAG device at our institution. Data was collected prospectively. Five patients were male. The mean age was 55 (range 40-87). All patients had a lesion limited to the isthmus. Initial management included resuscitation, blood pressure management, and treatment of associated injuries. The median interval between admission and repair was 6.8 days (range 0-16 days).
Results: Endovascular treatment was successful in all patients. All patients received a single device. The mean operative time was 46 minutes (range 35-60). Two patients received a perioperative cerebrospinal drainage catheter. None of the patients required an iliac conduit. There were no intraoperative or perioperative procedure related complications. The average hospital stay was 14 days (range 4-39). There was no in hospital mortality. The mean follow-up time was 6.6 months (range 1-11). Half of the patients were fully compliant with their surveillance imaging protocol.
Conclusion: The short term results for endovascular treatment of TAI using the TAG device appear favorable. Long term follow up is required to determine the effectiveness of this treatment strategy. Adherence to follow-up imaging protocols is especially challenging in this patient population. This may limit wide application of endovascular repair in this group of patients.