Mid-term Results of Blunt Traumatic Aortic Injury Treated with A Stent Graft in a Low-volume Institution
Jun Woo Cho, Oh Choon Kwon, Jae Seok Jang, Chul Ho Lee
Catholic University of Daegu, School of Medicine, Daegu, Korea, Republic of
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is widely performed for the treatment of blunt traumatic aortic injury (BTAI). While many of the early benefits of TEVAR are known, the long-term results are still unclear. Thus, we investigated the mid-term results of TEVAR for the treatment of BTAI.
METHODS: Patients who underwent TEVAR for the treatment of BTAI from January 2009 to December 2019 at a tertiary institution were included in this study. For the mid-term results, we evaluated survival rate, endoleak, and state of the previously injured aorta during the follow-up period. In order to properly evaluate the mid-term results, we also investigated the early results, which included technical success rate, spinal cord injury, stroke, and 30-day mortality.
RESULTS: A total of 18 patients underwent TEVAR for the treatment of BTAI during the study period with a mean follow-up of 76 months. The mean patient age was 48.72 years and only two were female. The technical success rate was 100%, and there was no 30-day mortality, stroke, or spinal cord injury. One patient had intramural hematoma, two had aortic rupture, and the other had focal aortic dissection. Twelve patients had zone 3 lesions, and four patients had zone 2. One patient had a lesion in zone 1, and one patient had a zone 0 lesion; both of these patients were treated with a hybrid procedure. Only one patient underwent left common carotid artery to left subclavian artery bypass surgery for a zone 2 TEVAR. Until the final patient follow-up, no endoleaks were found in any of the patients, and the aortic lesion showed no signs of dissection or aneurysmal change. There were three late deaths with a 5-year survival rate of 83.0%, and all died of causes not related to aortic disease.
CONCLUSIONS: TEVAR had favorable initial and mid-term results for the treatment of BTAI. There were no stent-related complications in the remaining aortas, and the mid-term survival rate was excellent.