The Endovascular Treatment of the Aortic Trauma
Raupach J.1, Ferko A.2 , Lojík M.1, Krajina A.1, Dominik J.3, Harrer J.3
'Radiologická klinika, Fakultní nemocnice, Hradec Králové, přednosta prof. MUDr. P. Eliáš, CSc. 2Katedra Válečné chirurgie, Fakulta vojenského zdravotnictví, Hradec Králové, přednosta doc. MUDr. A. Ferko, CSc. 3Kardiochirurgická klinika, Fakultní nemocnice, Hradec Králové, přednosta doc. MUDr. J. Harrer, CSc. |
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Summary:
Background: Traumatic injuries of the thoracic aorta are very frequent during motor vehicle accidents with sudden decelera-
tion. Spirál CT has become the modality of choice for evaluating significant blunt trauma and grading systém for aortic
injury has been developed. Immediate diagnosis, introduction of antihypertensive therapy and endovascular treatment by
means of stentgraft give a better chance for patients with blunt aortic injury.
Aim: Prospective evaluation of results of endovascularly treated patients with blunt aortic injury.
Materials and Methods: We prospectively followed patients after endovascular treatment of acute aortic injury. Diagnosis was
based on chest x-ray and CT examination. Stentgrafts were placed under fluoroscopic guidance and patients were routinely
followed by CT and clinical visit.
Results: Between December 1999 and September 2004 we endovascularly treated seven patients (6 men, 1 woman, mean age
41.7 years) for blunt aortic injury of the thoracic aorta. Stentgraft was implanted between 5 hours and 6 days (mean 3.2 days)
after injury. Seven stentgrafts were implanted in 7 patients in total. One patient died due to failure of endovascular technique
for collapsed stentgraft. A new onset of lower legs paraparesis was detected in one patient. Other five patients are regularly
followed (3-55 months, mean 30.7 months) without any complications.
Conclusion: Endoluminal technique can be ušed successfully in the immediate repair of aortic trauma. At present time in our
center, treatment by means of the stentgraft placement is the first line therapy in injured patients. It allows rapid stabilization
of aortic trauma and further treatment of other injuries.
Key words:
blunt thoracic aortic injury - antihypertensive therapy - delayed operation, endovascular treatment - stentgraft
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