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Acute traumatic aortic rupture: early stent-graft repair

Lachat, M. ; Pfammatter, T. ; Witzke, H. ; Bernard, E. ; Wolfensberger, U. ; Künzli, A. ; Turina, M.

In: European Journal of Cardio-Thoracic Surgery, 2002, vol. 21, no. 6, p. 959-963

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    Titre
    • Acute traumatic aortic rupture: early stent-graft repair
    Auteur
    • Lachat, M.. Clinic for Cardiovascular Surgery, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    • Pfammatter, T.. Department of Radiology, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    • Witzke, H.. Clinic for Cardiovascular Surgery, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    • Bernard, E.. Institute of cardiovascular anesthesia, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    • Wolfensberger, U.. Department of Radiology, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    • Künzli, A.. Clinic for Cardiovascular Surgery, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    • Turina, M.. Clinic for Cardiovascular Surgery, Zurich University Hospital, 100 Rämistrasse, CH-8091 Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Cardio-Thoracic Surgery, 2002, vol. 21, no. 6, p. 959-963. Elsevier Science B.V.
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:299553
    Summary
    Objective: Prospective evaluation of early stent-graft repair of acute traumatic aortic rupture. Methods: Twelve patients with acute traumatic aortic rupture of the descending aorta, out of a series of 337 endovascular aortic procedures, were treated by implantation of self-expanding stent-grafts. The procedures were performed within a mean post-injury time-period of 5±7 days (median: 1 day). The feasibility of stent-grafting was assessed by CT scanning and echography. Implantation was performed under local (n=6), or general anesthesia (n=6) if patients were already intubated (n=5) or required a common iliac artery access (n=1). Results: The immediate technical success rate was 100%. There were no post-procedure complications in all but one patient, who died 12 h postoperatively (8% mortality). Complete sealing of the aortic rupture in the remaining 11 patients was confirmed by postoperative CT scans. There were no intervention-related morbidity or mortality during the mean follow-up of 17 months. One patient with peri-graft leakage was successfully repaired with an additional stent-graft 12 months postoperatively. Conclusion: Non-delayed or early stent-grafting in acute traumatic rupture of the descending aorta is feasible. This technique seems to be a valuable option, in particular when associated lesions may interfere with the surgical outcome. Immediate post-procedural CT scanning and/or echography should be performed, in order to rule out residual leakage