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Trend of management of traumatic thoracic aortic injuries in a single center.

Vascular 2014 April
The purpose of this study was to review the shift in the trend of management and mid-term outcomes of all patients who sustain thoracic aortic injury. A Retrospective analysis was performed of all patients sustaining blunt thoracic aortic trauma admitted to our unit. Forty-seven patients were presented with injury to the thoracic aorta following blunt chest injury. Ten patients underwent open surgical repair of their thoracic aortic injury. The mean age ± SD (range) was 29.4 ± 7.9 years (18-41) with a mean Injury Severity Score (ISS) of 41 ± 14.7 (25-75). Fifteen patients underwent thoracic endovascular repair for blunt aortic transections with a mean age of 35.1 ± 14.5 years (17-65), mean ISS of 40.8 ± 13.9 (20-75) and an average length of hospital stay of 25.6 ± 14.5 days (3-77). The mean aortic diameter proximal to the aortic injury was 23.46 ± 3.02 mm (19-28) with a mean aortic angulation of 58.46° ± 17.73 (44-80°). The mean oversizing was 24.4 ± 5.4% (17-32%). At our institution, there has been a paradigm shift in the emergent repair of blunt thoracic aortic injury from open surgery to endovascular repair. Oversizing of the stent-graft did not translate to a poorer outcome.

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