Novel Endovascular Treatment of Blunt Thoracic Aortic Trauma

OBJECTIVE- Endovascular repair of thoracic aortic trauma is a clinical reality. We seek to report a single center’s mid-term experience with a novel endovascular technique to treat blunt thoracic aortic trauma (BAT).
METHODS- Records from patients treated with self-expanding stents (Wallstent®, Boston Scientific®) lined with infrarenal aortic endograft extender cuffs (Gore Excluder®) were reviewed. Indications, operative records, follow-up imaging and clinical status were recorded.
RESULTS- Between May 2004 and August 2007 10 patients with BAT were treated at our institution with self-expanding stents lined with aortic extender cuffs. Nine were secondary to motor vehicle collisions and one was related to a fall. Average injury severity score (ISS) on admission was 43. All procedures were successfully completed. One polytrauma patient died of multisystem failure post-operatively. The rest are alive with a mean follow-up of 15 months.
CONCLUSIONS- Treatment of BAT with self-expanding stents (Wallstent®, Boston Scientific®) lined with infrarenal aortic endograft extender cuffs (Gore Excluder® ) is a readily available, and flexible endovascular technique with low morbidity and mortality. It is particularly useful in the multiply injured patient with a normal sized aorta. Ongoing follow-up is required.