Aneurysmal disease after blunt injury of the thoracic aorta / 中华普通外科杂志

ABSTRACT

Objective To sum up the experience in treating thoracic aortic aneurysmal disease caused by blunt injury.Methods From September 2003 to March 2009,12 Patients were admitted into our center due to thoracic aortic aneurysmal disease after blunt injury,including 8 Stanford type B aortic dissections and 4 descending aorta pseudoaneurysms.Diagnosis was established by CT angiography and re-evaluated by angiography before endovascular treatment. Once severe co-morbidity due to iniury wag stabilized,endovascular repair of the lesions Was carried out with stent-graft implantation.Follow.up was done by CTA at 3 months、6 months、1 year and then annually postoperatively.Results Eleven patients underwent endovascular surgery,while 1 died before intervention.Technical success was achieved in all patients with left subclavian artery intentionally covered in 6 cases.Endoleak Was observed in 3 cases andmanaged with balloon dilation in 2 easels.9 cases were followed up without mortality,including 6 disseetions and 3 pseudoaneurysms.No ischemic symptom of left uppar extremity or positive neurological sign or paralysis were observed,CTA revealed no newly-developed dissection or aneurysm、no endoleak or stent migration. Conclusion Thoracic aortic aneurysmal disease after blunt injury mostly locates in aortic isthmus;endovascular stent-graft implantation after stabilization of concurrent disease is effective.