J Cardiovasc Surg
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Comparative Study
Single-center experience with endovascular treatment of acute blunt thoracic aortic injuries.
Endovascular repair of the thoracic aorta (TEVAR) has been recently considered an appealing alternative to open treatment of traumatic aortic injuries. However, the use of this technique in emergency is often limited by hemodynamic instability, severe associated lesions and unavailability of adequate materials. Dedicated stent-grafts are not currently available. We report our results in treating blunt traumas of the thoracic aorta using three different commercially available stent-grafts. METHODS Between 2003 and 2010, 28 patients (22 males, mean age 38.9±12.1 years) underwent TEVAR for a traumatic aortic lesion. A total-body computed tomography angiography (CTA) was performed in all cases to establish the diagnosis of aortic rupture and evaluate associated injuries. After TEVAR, patients were followed-up with CTA of the chest before discharge from the hospital, at 6 months and yearly thereafter. ⋯ In our experience, endovascular treatment of acute traumatic thoracic aortic injuries using different commercially available stent-grafts allows to obtain satisfactory short term results.
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Spinal cord ischemia is a well-known complication in the treatment of thoracoabdominal aneurysms (TAAA). Despite the fact that endovascular treatment of TAAA is less invasive, spinal cord ischemia rate is not reduced if compared to open repair. ⋯ In conclusion we state that our first experience demonstrates the value of assessing spinal cord function during extensive endovascular TAAA repair with subsequent strategies to prevent paraplegia.