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Thoracic Branch Endograft Use In Blunt Aortic Trauma And Acute Aortic Syndrome
Travis G. Hughes, MD, Ryan W. King, MD, Tana L. Repella, MD, PhD, Dong H. Lee, MD, David J. Minion, MD, Samuel C. Tyagi, MD.
University of Kentucky, Lexington, KY, USA.
OBJECTIVES: Endovascular treatment of traumatic thoracic aortic injuries and acute aortic syndrome in zones 2 and 3 can require coverage of the left subclavian artery with a thoracic endograft. The recent commercial availability of thoracic branched endoprostheses (TBEs) allow preservation of the left subclavian artery. We present a single center experience of five emergent TBEs for blunt aortic trauma and acute aortic syndrome.
METHODS: We retrospectively evaluated TBE cases with indications of blunt aortic trauma and acute aortic syndrome. Operative times, and post-operative complications were assessed.
RESULTS: Two blunt thoracic aortic injuries, two Type B aortic dissections, and a penetrating thoracic aortic ulcer were treated with TBE. All cases were a technical success. Percutaneous upper extremity access was via the radial or brachial artery in four and one cases, respectively. No cases had access site complications. For four cases two surgeons were present, and intravascular ultrasound was used in all dissection cases. The average procedure length ranged from 72 to 192 minutes. There were no mortalities in our series.
CONCLUSIONS: We find that treatment of blunt thoracic aortic trauma and acute aortic syndrome with a thoracic branched endograft is feasible, expedient, safe, and effect in an emergency procedure setting.
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