Endovascular repair of the aorta and aortic arch arteries damaged during mediastinoscopy

• Published in: Journal of vascular surgery Vol. 55; no. 4; pp. 1138 - 1140
• Main Authors: Smith, Sara-Jane, BM, Lyons, Oliver T.A., MRCS, Patel, Ashish S., MRCS, Clough, Rachel E., MRCS, Salter, Richard, FRCR, Bell, Rachel E., FRCS, Taylor, Peter R., FRCS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.2012; Elsevier
• Subjects: Adult; Aged; Aneurysm, False - etiology; Aneurysm, False - therapy; Angioplasty - methods; Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - injuries; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the aorta; Female; Follow-Up Studies; Hodgkin Disease - diagnosis; Hodgkin Disease - surgery; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - surgery; Male; Mediastinal Neoplasms - diagnosis; Mediastinal Neoplasms - surgery; Mediastinoscopy - adverse effects; Mediastinoscopy - methods; Medical sciences; Multivariate Analysis; Risk Assessment; Sampling Studies; Stents; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed - methods; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Cardiovascular disease; Endovascular route; Mediastinoscopy; Aorta arch; Aortic arch; Surgery
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2011.08.041

Despite advances in imaging techniques, mediastinoscopy remains an important tool for the staging of the mediastinum in non-small cell lung cancer and diagnosing lymphoma with mediastinal adenopathy. Injury to the arterial system during mediastinoscopy is infrequent but a potentially fatal complication. We report three cases of injury to the aorta and supra-aortic arteries sustained during mediastinoscopy. These were effectively managed by endovascular techniques. Patient recovery was uncomplicated and median length of stay was 3 days. This technique avoids major open surgery in a high-risk group of patients and may offer a mortality benefit and more rapid resumption of oncological treatment.