Traumatic thoracic aortic aneurysm: treatment with endovascular stent-grafts

Abstract

Purpose: To demonstrate the feasibility and safety of endovascular stent-graft placement for treatment of traumatic aortic aneurysm.

Materials and methods: Ten patients with traumatic aortic aneurysm were treated with endovascular stent-grafts. Three patients had an acute traumatic aneurysm; seven had a chronic aneurysm. Stent-grafts were constructed from modified Z-stents covered with woven polyester or expanded polytetrafluoroethylene graft material and were deployed through a 20-24-F delivery sheath in an exposed artery located remotely from the lesion.

Results: Stent-graft placement and thrombosis of the aneurysmal sac were successful in all patients. Major complications were encountered in three patients after endovascular treatment. One patient had a peri-graft leak; complete thrombosis of the aneurysmal sac was achieved after coil embolization of the leak. Transposition of the left subclavian artery was necessary to relieve left arm ischemia in another patient. In the third patient, stent placement in the left main stem bronchus was needed to relieve left lung atelectasis. All patients were alive and without complications during the follow-up period (mean, 15 months).

Conclusion: Transluminal placement of endovascular stent-grafts is a technically feasible method for treatment of traumatic thoracic aortic aneurysm and may be an effective alternative to open-chest surgery.