Stent-graft implantation in thoracic aortic injury

Abstract

Thoracic aortic injury (TAI) is associated with very high mortality rates. Although it occurs in less than 0.5% of all road traffic accidents, TAI is the second most common cause of death in this patient group. Until recently, the standard procedure in such cases was an open repair requiring left thoracotomy ap­proach and the implantation of an aortic prosthesis. The mortality rate in such cases reached up to 15% to 30%. Due to the high mortality and morbidity rates following the surgical repair, endovascular stent-grafting (thoracic endovascular aortic repair, TEVAR) has recently become primary treatment modality in TAI patients. Numerous reports in the literature indicate a significant reduction both regarding the rates of mortality rate and severe complications occurring in patients undergoing endovascular treatment. The aim of this paper was to analyse important issues associated with TEVAR basing on a series of four patients undergoing TEVAR for TAI in the Department of Vascular, General, and Oncologic Surgery, Copernicus Memorial Hospital, Lodz, Poland. The analysis of available literature and our own experience reveals that TEVAR seems to be the optimal treatment modality for TAI patients with concomitant severe injuries of other organs and systems.