Endovascular Therapeutic Strategies for Thoracic Aortic injuries in the Pediatric population. A Case Report and Review of Literature
MAEN ABOUL HOSN, Rachael Nicholson, Jospeh Turek, William John Sharp, Luigi Pascarella.
UNIVERSITY OF IOWA HOSPITAL AND CLINICS, IOWA CITY, IA, USA.
BACKGROUND: Traumatic aortic injuries in children and adolescents are rare. Although endovascular repair has become the preferred approach for such injuries in adults, open repair has endured as the gold standard approach in the pediatric population owing mainly to the smaller aortic and access vessel diameter and the scarcity of long term follow up data. METHODS: We report a successful endovascular repair of a traumatic thoracic aortic injury in an eight year old girl using a Zenith Alpha thoracic endograft (Cook Medical, Bloomington, Ind). We also present the results of our literature review on endovascular management of this rare condition. To our knowledge, this is the youngest patient to be successfully treated with endovascular thoracic aortic repair. CONCLUSIONS: Although open surgical repair is the gold standard for repair of traumatic aortic injuries in the pediatric population, new endovascular stent grafts with smaller delivery systems offers a viable alternative in carefully selected patients mainly those with concomitant injuries putting them at a prohibitive risk for open repair. Further studies are needed to study the long term durability of these grafts and their effect on the aorta.
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