Outcomes of Endovascular Repair of Acute Thoracic Aortic Injury: Interrogation of the New Zealand Thoracic Aortic Stent Database (NZ TAS)

Abstract 

Objectives

Report the New Zealand national experience of endovascular repair of acute traumatic thoracic aortic injuries (TTAIs).

Design

Retrospective analysis of the New Zealand thoracic aortic stent database between December 2001 and December 2007.

Materials and methods

Of the 134 patients on the database, 27 patients (20%) underwent endovascular repair of TTAI. Data collected included age, sex, cause of injury, details of the procedure, complications and mortality.

Results

Most patients were young, median age 20 (15–78), male (n=19, 70%), and involved in motor vehicle accidents (n=23, 85%). Median length of aorta stented was 117mm (77–200mm). Great vessel origins were covered intentionally in 23 (85%) patients, four (17%) requiring a hybrid procedure. Average procedure time was 98.3min (35–180). Primary technical success was 96%, secondary technical success 100%. Endoleaks were observed in four (15%) patients, one requiring a second endovascular procedure. There were no conversions to open surgery. Procedure-related complications occurred in four (15%) patients. No patient developed cord injury. All cause mortality at 30 days is one (4%) and at discharge is two (7%) due to associated poly-trauma.

Conclusion

Our results add further evidence of the safety of endovascular repair of thoracic aortic injury and compare favourably with those of other centres.

Keywords (MeSH): Aorta, Thoracic [A07.231.114.056.372], Thoracic injuries [C21.866.891], Radiography, Interventional [E01.370.350.700.725], Surgery [G02.403.810.762]