Asmat Atasha, Tan Lenny, Caleb Michael George, Lee Chuen-Neng, Robless Peter Ashley
Department of Cardiac, Thoracic & Vascular Surgery, National University Hospital, Singapore.
Asian Cardiovasc Thorac Ann. 2009 Oct;17(5):458-61. doi: 10.1177/0218492309348624.
The conventional treatment of traumatic thoracic aortic transection is open surgical repair but it is associated with high rates of morbidity and mortality, particularly in patients with multiple injuries. We reviewed our experience of endovascular repair of traumatic thoracic aortic transection. Between March 2002 and December 2007, 7 patients (male 6, female 1; mean age 40 years) with multiple injuries secondary to blunt trauma underwent endovascular stenting. One patient required adjunctive surgery to facilitate endovascular stenting. Mean intensive care unit stay was 8.6 days (range, 3-16 days). Arterial access in all patients was obtained by femoral cut-down. The mean operating time was 122 min. Technical success was achieved in all cases. There was no mortality. One patient suffered a right parietal stroke, but none developed procedure-related paralysis. The mean follow-up period was 18.6 months (range, 6-48 months). There was no evidence of endoleak, stent migration, or late pseudoaneurysm formation on follow-up computed tomography. Endovascular stents can be used to treat traumatic thoracic aortic transection, with low rates of morbidity and mortality. Although early and midterm results are promising, the long-term durability of endovascular stenting for traumatic thoracic aortic transection remains unknown.
创伤性胸主动脉横断的传统治疗方法是开放性手术修复，但该方法与高发病率和死亡率相关，尤其是在多发伤患者中。我们回顾了我们采用血管腔内修复治疗创伤性胸主动脉横断的经验。在2002年3月至2007年12月期间，7例（男6例，女1例；平均年龄40岁）因钝性创伤继发多发伤的患者接受了血管腔内支架置入术。1例患者需要辅助手术以利于血管腔内支架置入。平均重症监护病房停留时间为8.6天（范围3 - 16天）。所有患者均通过股动脉切开获得动脉入路。平均手术时间为122分钟。所有病例均取得技术成功。无死亡病例。1例患者发生右顶叶卒中，但无一例出现与手术相关的瘫痪。平均随访期为18.6个月（范围6 - 48个月）。随访计算机断层扫描未发现内漏、支架移位或晚期假性动脉瘤形成的证据。血管腔内支架可用于治疗创伤性胸主动脉横断，发病率和死亡率较低。尽管早期和中期结果令人鼓舞，但血管腔内支架置入术治疗创伤性胸主动脉横断的长期耐久性仍不清楚。
