Traumatic aortic rupture: our experience

Aim. The aim of the present study was to evaluate the results obtained in a single center using the endovascular procedure (TEVAR) in traumatic thoracic aortic rupture. Methods. Eleven patients, 7 men and 4 women, mean age 42.5 years, presented a traumatic thoracic aortic rupture and 9 of them underwent TEVAR. The diagnosis of traumatic rupture of aorta was based on a spiral angio-CT, which showed aortic isthmus rupture in 10 patients and rupture of the thoracic aorta down to the thoracic-abdominal transition in the remaining case. Ten patients showed a politraumatic condition. In 8 patients the exclusion of the aortic transected tract occurred by the release of a single device while, due to the migration of the prosthesis during the opening phase, in one case the implantation of a second prosthetic segment was necessary. Results. Operative survival was 100%, while there was one death due to severe bone and cerebral lesions in third post-operative day. No open conversion was required. There was a type 2 endoleak, which solved spontaneously. After TEVAR nor paraplegia nor neurological complications occurred. One year later a patient developed an upper left extremity weakness due to the proximal migration of the device with occlusion of the ostial left subclavian artery which was treated by a carotid subclavian artery bypass. Conclusion. TEVAR showed to be less invasive, with low rate of mortality and excellent short-term results. The lack of long-term results does not allow us to indicate it as first choice treatment in young subjects.