Martin Cecile, Thony Frederic, Rodiere Mathieu, Bouzat Pierre, Lavagne Pierre, Durand Michel, Chavanon Olivier
Thoracic and Vascular Centre, Cardiac Surgery Clinic, Grenoble University Hospital, Grenoble, France.
Central Radiology and Medical Imaging Service, Grenoble University Hospital, Grenoble, France.
Eur J Cardiothorac Surg. 2017 Apr 1;51(4):767-772. doi: 10.1093/ejcts/ezw369.
Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients.
Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft.
In total, 48 men (80%) were included; the average age was 43 ± 17 years [17; 79]. The median time between the accident and endovascular repair was 6 h. Endovascular repair was successful in all cases with no cerebrovascular or paraplegia after treatment. Seventeen patients (27.3%) received a total coverage of the left subclavian artery; one of them received a subclavian carotid bypass. Mean follow-up was 5 years with a maximum of 14 years. There was no repeat surgery related to the aorta during follow-up. No stent graft failure, neurological or ischaemic event related to the stent graft was noted. One patient had a type 1 endoleak without any reintervention. The survival rate was 86.5% in 1 year, 81.6% in 5 years and 75.3% in 10 years.
Treatment of injuries of the aortic isthmus with stent graft seems to be a safe long-term technique; we did not notice any event related to the stent graft during the follow-up.
主动脉峡部创伤的血管腔内修复是一种安全的技术，已显示出良好的短期效果。然而，这些支架移植物的未来仍未得到研究，尤其是在年轻患者中。
2000年1月至2014年12月期间，60例患者接受了主动脉峡部损伤的血管腔内主动脉支架移植物治疗。通过静脉造影计算机断层扫描或与胸部X线相关的磁共振成像进行随访，以控制支架移植物。
总共纳入48名男性（80%）；平均年龄为43±17岁[17；79]。事故与血管腔内修复之间的中位时间为6小时。所有病例血管腔内修复均成功，治疗后无脑血管意外或截瘫。17例患者（27.3%）接受了左锁骨下动脉的完全覆盖；其中1例接受了锁骨下动脉颈动脉旁路移植术。平均随访时间为5年，最长为14年。随访期间没有与主动脉相关的再次手术。未发现与支架移植物相关的支架移植物故障、神经或缺血事件。1例患者有1型内漏，未进行任何再次干预。1年生存率为86.5%，5年生存率为81.6%，10年生存率为75.3%。
用支架移植物治疗主动脉峡部损伤似乎是一种安全的长期技术；我们在随访期间未发现任何与支架移植物相关的事件。
