Traumatic thoracic aortic aneurysm: treatment with endovascular stent-grafts.
Kato N, Dake MD, Miller DC, Semba CP, Mitchell RS, Razavi MK, Kee ST
PURPOSE: To demonstrate the feasibility and safety of endovascular stent-graft
placement for treatment of traumatic aortic aneurysm. MATERIALS AND METHODS:
Ten patients with traumatic aortic aneurysm were treated with endovascular
stent-grafts. Three patients had an acute traumatic aneurysm; seven had
a chronic aneurysm. Stent-grafts were constructed from modified Z-stents
covered with woven polyester or expanded polytetrafluoroethylene graft
material and were deployed through a 20-24-F delivery sheath in an exposed
artery located remotely from the lesion. RESULTS: Stent-graft placement
and thrombosis of the aneurysmal sac were successful in all patients. Major
complications were encountered in three patients after endovascular treatment.
One patient had a peri-graft leak; complete thrombosis of the aneurysmal
sac was achieved after coil embolization of the leak. Transposition of
the left subclavian artery was necessary to relieve left arm ischemia in
another patient. In the third patient, stent placement in the left main
stem bronchus was needed to relieve left lung atelectasis. All patients
were alive and without complications during the follow-up period (mean,
15 months). CONCLUSION: Transluminal placement of endovascular stent-grafts
is a technically feasible method for treatment of traumatic thoracic aortic
aneurysm and may be an effective alternative to open-chest surgery.
