Endovascular stent-graft treatment for blunt aortic injury

Background: Thoracic aortic injury resulting from blunt trauma is usually fatal and almost always associated with multiple, complex, nonaortic injuries that can adversely affect standard surgical repair of the aorta. Endovascular stent-graft treatment offers these patients a less invasive operative treatment option. Methods and Results: Between January 2002 and October 2003, 6 patients with blunt aortic injury (BAI) were treated with a stent-graft. In all cases endovascular management was selected because of associated polytrauma or comorbidities. All stent-grafts were homemade and deployed through the femoral artery with 18-20 Fr delivery sheaths. There were no cases of perioperative death, renal failure, or neurologic complication. In one patient the postoperative computed tomography scan showed proximal endoleak requiring additional balloon dilatation and stenting. No other endoleaks were observed by CT in the acute phase. None of the follow-up CT scans revealed evidence of endoleak, migration, or alteration of the stent-graft. Conclusions: Endovascular repair for BAI is technically feasible and is an alternative to open surgery for high-risk patients.