Objective

Thoracic trauma can result in acute aortic lesions. Repair of these lesions can be performed with either open surgery or endovascular techniques. We aim to review our results in this category of patients.

Methods

We interrogated our prospective database to identify all consecutive patients who underwent open or endovascular repair (OR/ER) for traumatic aortic disruption between 1997 and 2014. Seventeen patients (14 males) underwent OR (n=9) or ER (n=8) of acute aortic disruption. Median (range) age for OR and ER group was 40 (21-76) vs. 26 (25-74), respectively (p=0.42). Two patients in the OR group underwent concomitant arch repair.

Results

There was one in-hospital death in each group. Median (range) of hospital length of stay was 18 (6-38) vs. 6.5 (2-21) days for OR vs. ER (p=0.93). There were no postoperative strokes or spinal cord injury. At 16 year follow-up (median 4.8 years) one-, and five-year estimates of survival in the OR and ER group were 89 vs. 87%, and 89 vs. 73%, respectively (p=0.48). Freedom from reintervention on the thoracic aorta was 100%.

Conclusion

In patients with traumatic aortic injury, OR and ER offer excellent results. ER is less invasive and may be associated with a reduction in hospital stay. In addition, in a relatively young group of patients, ER has proved to be durable thus far. Long-term aortic follow-up is mandatory in this group. Patients with suspected aortic trauma should be transferred to major trauma centres with appropriate expertise in the management of aortic transection with both OR and ER if other injuries allow