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Eur J Cardiothorac Surg 2002;21:959-963
© 2002 Elsevier Science NL
a Clinic for Cardiovascular Surgery, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
b Department of Radiology, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
c Institute of cardiovascular anesthesia, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
Received 21 September 2001; received in revised form 11 January 2002; accepted 17 January 2002.
* Corresponding author. Tel.: +41-1-255-1111; fax: +41-1-255-5715
e-mail: mario.lachat{at}chi.usz.ch
Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakage.
Key Words: Stent-graft • Endovascular • Acute traumatic aortic rupture
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