Acute Traumatic Thoracic Aortic Injury

Luca Di Marco; Davide Pacini; Roberto Di Bartolomeo

doi:10.12945/j.aorta.2013.12-009

AORTA, Table of Contents

CC BY 4.0 · Aorta (Stamford) 2013; 01(02): 117-122
DOI: 10.12945/j.aorta.2013.12-009

State-of-the-Art Review

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Acute Traumatic Thoracic Aortic Injury

Considerations and Reflections on the Endovascular Aneurysm Repair

Luca Di Marco

¹Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

,

Davide Pacini

¹Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

,

Roberto Di Bartolomeo

¹Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

› Author Affiliations

Abstract

Traumatic rupture of the thoracic aorta is a life-threatening lesion and it occurs in 10 to 30% of fatalities from blunt thoracic trauma and is the second most common cause of death after head injury. Immediate surgery is often characterized by a high mortality and morbidity rate. Delayed repair of traumatic aortic injuries has significant survival benefits and a much lower mortality rate compared with early open repair. Despite developments in operative techniques, there still remains considerable operative mortality and morbidity associated with a surgical approach even if delayed. Endovascular stent grafts for the thoracic aorta represents an alternative to the conventional approach for traumatic aortic rupture. Because of the lower invasivity avoiding thoracotomy and use of heparin, endovascular repair can be applied in acute patients without the risk of destabilizing pulmonary, head or abdominal traumatic lesions. However, despite the good deal of convincing evidence for endovascular treatment for thoracic aortic diseases and for traumatic aortic injuries as a valid and efficacious alternative to surgery, several reports show a variety of late complications of thoracic endografts especially for first-generation stent-grafts. In light of this, is the endovascular treatment really safe, efficacious and free from complications in the long term? This manuscript aims to offer a moment of reflection on this important chapter of aortic pathology.

Key Words

Aortic - Traumatic - Endovascular - Acute injury

Full Text

References

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