Reparación endovascular de la rotura aórtica torácica en traumatismos cerrados. Presentación de dos casos / Endovascular repair of ruptured thoracic aortas in closed traumatic injuries. Two case reports

RESUMEN

Objetivo. Presentar nuestra experiencia en el manejo de la rotura traumática de la aorta torácica en los traumatismoscerrados. Introducción. La rotura de la aorta torácica en traumatismos cerrados es una entidad grave, asociadaa una elevada morbimortalidad con el tratamiento quirúrgico convencional. La cirugía endovascular se está imponiendoen el tratamiento de la patología vascular torácica, por lo que, dada su menor agresividad, parece estar aún másindicada en esta patología. Casos clínicos. Caso 1 varón de 34 años que, tras un accidente de motocicleta, presentabaun politraumatismo con múltiples fracturas óseas, lesiones abdominales y craneales. Fue trasladado a nuestro centrocon un diagnóstico de rotura aórtica torácica e intervenido de forma urgente mediante dos endoprótesis. El control a los24 meses se observó la exclusión completa de la lesión sin fugas. Caso 2 varón de 19 años que, tras un accidente de tráfico,presentaba un politraumatismo con múltiples fracturas óseas, lesiones abdominales y craneales. Fue trasladado anuestro centro con un diagnóstico de rotura aórtica e intervenido de forma urgente mediante una endoprótesis. El controla los seis meses se observó la exclusión completa de la lesión sin fugas. Conclusión. La rotura de la aorta torácica entraumatismos cerrados es una entidad de elevada morbimortalidad y la reparación endovascular, a nuestro juicio, constituyeuna opción válida

ABSTRACT

Aim. To present our experience in the management of traumatic rupture of the thoracic aorta in closed trauma. ;;Introduction. Rupture of the thoracic aorta due to closed traumatic injuries is a severe condition that is associated to ;;high morbidity and mortality rates with conventional surgical treatment. Endovascular surgery is becoming the ;;preferred technique in thoracic vascular pathologies and therefore, due to its being less aggressive, it seems to be even ;;more indicated in this pathology. Case reports. Case 1 a 34-year-old male who, following a motorcycle accident, had ;;multiple traumatic injuries including several fractured bones and abdominal and cranial injuries. He was brought to our ;;centre with a diagnosis of rupture of the thoracic aorta and was submitted to emergency surgical treatment involving the ;;placement of two stent-grafts. The control visit at 24 months revealed complete exclusion of the lesion with no leaks. ;;Case 2 a 19-year-old male who, following an automobile accident, had multiple traumatic injuries including several ;;fractured bones and abdominal and cranial injuries. He was brought to our centre with a diagnosis of rupture of the aorta and was submitted to emergency surgical treatment involving the placement of a stent-graft. The control visit at six ;;months revealed complete exclusion of the lesion with no leaks. Conclusions. Rupture of the thoracic aorta in closed ;;traumatic injuries is a condition with high morbidity and mortality rates and endovascular repair is, in our opinion, a valid therapeutic option