Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury: Single-Center Experience in a Developing Country

Abstract

Background: Blunt thoracic aortic injury (BTAI) is a lethal condition. The most common intervention is no longer open aortic repair (OAR), it has been almost entirely replaced by thoracic aortic endovascular repair (TEVAR). Objectives: In the present study, we aimed to share our experience in emergency TEVAR and address some difficulties that have been encountered. Methods: In this retrospective study, all patients with blunt chest trauma between July 2014 and April 2020 were identified. Only patients with BTAI who were treated by emergency TEVAR were included. Demographic and clinical data were collected and analyzed. Results:A total of 657 cases of blunt chest trauma were identified. Only 7 cases were found to have BTAI who underwent emergency TEVAR; six patients (85.7%) were males, with a mean age (±SD) of 29.5±8.5 years and one as a 39-year-old female. Motor vehicle accident (MVA) was the mechanism of injury (100%). Two patients (27.6%) had grade-II, 4 patients (57.1%) had grade-III, and 1 patient (14.2%) had grade IV aortic injuries. Technical success was achieved in all cases (100%). No peri-procedural-related mortality and morbidity. No graft-related complications or re-interventions during the average follow-up of 23.3±8.6 months. Conclusions: Despite our lack of experience in OAR for BTAI, TEVAR has provided us with an alternative treatment option for this life-threatening condition. Considering the challenges that may be encountered in developing countries, our results were similar to what has been reported in the literature.