Endovascular treatment of traumatic thoracic aortic transection

Traumatic thoracic aortic transection (TTAT) results from a high positive or negative G force exerted on the body. It is associated with a high rate of lethality. Precipitating events are especially traffic accidents in which the patients have usually sustained multiple injuries, and traumatic rupture of the aorta represents the second most frequent cause of death after head injuries. While clinical examinations and conventional diagnostic radiology only suggest the presence of TTAT, it can be reliably diagnosed with the aid of multidetector-row computed tomography (CT). Consequent to the successful introduction of implantable endovascular stent grafts to repair various forms of aortic aneurysms, this method has become an established approach to treating traumatic transections and has to a large extent replaced open surgery with its inherently high morbidity and mortality. Endovascular therapy has been successfully performed at the UKB in eight patients with TTAT since 2006. While one patient died from septic multiorgan failure, no procedural complications were observed. An occurrence of endoleak could be excluded in all cases based on CT monitoring.