Our Experience with Endovascular Repair of Descending Thoracic Aortic Injury after Blunt Trauma

Document Type : Original Article

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Abstract

Background: Thoracic endovascular aneurysm repair (TEVAR) allows minimally invasive efficient and rapid management of patients with traumatic aortic injury. In the past surgery was the only management option till the first stent was done in 1994, and nowadays TEVAR became the treatment of choice.
Objective: This study aimed to share our experience and show how TEVAR is efficient and safe in traumatic descending aortic injury.
Patients and Methods: A prospective study that was done in multicentre in Egypt and KSA. A total number of 49 patients had emergent TEVAR for traumatic descending thoracic aortic injury.
Results: 58 patients presented to our centers with blunt traumatic descending aortic injury, out of them, 9 (15.52%) patients had grade 1 and were treated by conservative management, and 49 (84.48%) patients had emergent TEVAR for Grades II and III traumatic (no patient presented by grade IV) in the first 24 hours from trauma except 2 patients had TEVAR in the 2nd day after stabilization of their general condition due to associated injuries. In forty-six (93.88%) patients the aortic injury was in the vicinity of the origin of the left Subclavian artery, however, three (6.12%) of the injuries occurred at mid descending Thoracic aorta. In the study group, forty-four (89.8%) patients had concomitant injuries. In all our patients, one stent graft of 10 cm in length was enough to exclude the injured part of the aorta and the width was variable according to aortic diameter.
Conclusion: TEVAR is safe, easy, and practical management of traumatic descending thoracic aortic injury.
 
 

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The Egyptian Journal of Hospital Medicine
Volume 87, Issue 1
April 2022
Pages 2228-2233

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