Endovascular Treatment of Traumatic Descending Aortic Lesions:
Nine Years of Experience
Emanuela de Cillis, M.D., Ph.D.
Candidate
Interventional Cardiologist
Institute of Cardiac Surgery
Vito Paradiso, M.D.
Cardiac Surgeon, Assistant Professor
Institute of Cardiac Surgery
Ayman Elmeghory, M.D.
Research Fellow of Interventional Laboratory
Institute of Cardiac Surgery
Francesco Tunzi, M.D.
Research Fellow of Interventional Laboratory
Institute of Cardiac Surgery
Gianni Raguso, B.A.N.
Nurse Coordinator
Institute of Cardiac Surgery
Alessandro Santo Bortone, M.D., Ph.D.
Assistant Professor, Chief of Interventional Laboratory
Institute of Cardiac Surgery
Department of Emergency and Organs Transplantation
University of Bari
Bari, Italy
Aortic injury from sudden deceleration is the most common traumatic condition of the thoracic aorta encountered clinically. Open surgical repair is still associated today with a high-risk setting. Recently, stent-graft treatment is emerging as an alternative to conventional surgery due to its less traumatic nature in patients affected by traumatic aortic lesions, especially in concomitance with multiple associated lesions. From March 1999 to June 2009, 57 patients admitted with a diagnosis of acute and chronic aortic lesions underwent endovascular repair. In 38 cases, traumatic aortic rupture was detected in the acute phase and associated lesions were present at various grade in all patients, whereas in 19 cases aortic injury was identified in the chronic phase. The endovascular treatment was successful in all cases affected both by acute and chronic aortic injury. None of the patients died during the follow-up, as well as no cases of perigraft leakage have been detected so far. Endovascular repair represents the first choice of treatment in patients with traumatic aortic lesions. Indeed, the severity of co-existing lesions could be adversely affected by conventional surgical treatment, also with consideration of its high morbidity rate due to thoracotomy.
