Sage Journals: Discover world-class research

Abstract

Purpose:

To report the immediate endovascular treatment of a thoracic aortic tear secondary to blunt trauma.

Methods and Results:

A 39-year-old man was injured in a motor vehicle collision. In addition to significant trauma to the head, chest, and abdomen, there were signs of a deceleration injury to the thoracic aorta. After urgent celiotomy to repair a lacerated spleen, the thoracic aortic transection was treated intraluminally using an endograft made of Gianturco Z-stents covered with polytetrafluoroethylene. The patient recovered from his injuries, and the thoracic endograft shows no evidence of endoleak 7 months after treatment.

Conclusions:

Endoluminal techniques can be used successfully in the immediate repair of thoracic aortic injuries.

Keywords

stent-graft Gianturco Z-stent polytetrafluoroethylene automobile accident deceleration injury

Get full access to this article

View all access options for this article.

References

Fabian

Richardson

Croce

. Prospective study of blunt aortic injury: multicenter trial of the American Association for the Surgery of Trauma. J Trauma. 1997;42:374–380.

Smith

Chang

. Traumatic rupture of the aorta: still a lethal injury. Am J Surg. 1986;152:660–663.

Kalmar

Puschel

Stubbe

. Delayed surgical therapy of acute aortic rupture. Zentralbl Chir. 1996;121:750–755.

DelRossi

Cernaianu

Madden

. Traumatic disruptions of the thoracic aorta: treatment and outcome. Surgery. 1990;108:864–870.

Schmidt

Wood

Razzouk

. Primary repair of traumatic aortic rupture: a preferred approach. J Trauma. 1992;32:588–592.

von Oppell

Dunne

De Groot

. Traumatic aortic rupture: twenty-year meta-analysis of mortality and risk of paraplegia. Ann Thorac Surg. 1994;58:585–593.

Nocolosi

Almassi

Bousamra

. Mortality and neurologic morbidity after repair of traumatic aortic disruption. Ann Thorac Surg. 1996;61:875–878.

Cowley

Turney

Hankins

. Rupture of thoracic aorta caused by blunt trauma. A fifteen-year experience. J Thorac Cardiovasc Surg. 1990;100:652–660.

Shkrum

McClafferty

Green

. Mechanisms of aortic injury in fatalities occurring in motor vehicle collisions. J Forensic Sci. 1999;44:44–56.

10.

Camp

Shackford

. Outcome after blunt traumatic thoracic aortic laceration: identification of a high-risk cohort. Western Trauma Association Multicenter Study Group. J Trauma. 1997;43:413–422.

11.

Maggisano

Nathens

Alexandrova

. Traumatic rupture of the thoracic aorta: should one always operate immediately? Ann Vasc Surg. 1995;9:44–52.

12.

Rousseau

Soula

Perreault

. Delayed treatment of traumatic rupture of the thoracic aorta with endoluminal covered stent. Circulation. 1999;99:498–504.

13.

Semba

Kato

Kee

. Acute rupture of the descending thoracic aorta: repair with use of endovascular stent-grafts. J Vasc Interv Radiol. 1997;8:337–342.

14.

Dake

Miller

Mitchell

. The “first generation” of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta. J Thorac Cardiovasc Surg. 1998;116:689–703.