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13 October 2021 : Clinical Research

[In Press] Endovascular Repair of Thoracic Aorta Injury: 17 Years of Single-Center Experience

Václav Procházka ORCID logo12ABEF, Jan Roman34BCEF, František Jalůvka34AEF, Tomáš Jonszta ORCID logo12E, Adéla Vrtková5BCDE, Leopold Pleva6AEF, Vladimír Ječmínek7AE, Jiří Sieja8E, Radim Brát8ABF

DOI: 10.12659/MSM.934479

Med Sci Monit In Press; DOI: 10.12659/MSM.934479  

Available online: 2021-10-13, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Traumatic thoracic aortic transection is one of the most severe complications of high-energy injuries, but patients rarely receive treatment, and it is fatal in the vast majority of cases. Due to the complexity of surgical revision for transection, endovascular repair with stent graft implantation is the preferred approach.
MATERIAL AND METHODS
We retrospectively analyzed the short-term and long-term treatment results for 31 patients (29 men, 2 women) treated at the Interventional Radiology Department, University Hospital Ostrava, for the isthmus part of a descending thoracic aorta injury between 2004 and 2020.
RESULTS
The median patient age was 48 years (interquartile range [IQR]: 28-63 years). The most common causes of injury were traffic accidents and falls or jumps, with the trauma location at the Ishimaru zones 2 to 4 of the aortic isthmus. Aortic stent grafts were successfully implanted in all patients; 13% of patients had complications and 10% died due to the trauma severity. The median procedure duration was 30 min (IQR: 25-43 min) and the median hospital stay was 29 days (IQR: 28-63 days).
CONCLUSIONS
Aortic stent graft implantation appears to be a safe and effective method for dealing with thoracic aorta injury, with a low complication rate and high patient survival. The endovascular approach is the method of choice for treating this severe disease, and a multidisciplinary approach for emergency medical treatment with a comprehensive trauma protocol is essential.

Keywords: Advanced Trauma Life Support Care; Aortic Diseases; Endovascular Procedures

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