Management of traumatic aortic rupture. About 37 cases

• Published in: Journal des maladies vasculaires Vol. 38; no. 1; p. 13
• Main Authors: Denguir, R, Frikha, I, Kaouel, K, Abdennadher, M, Ziadi, J, Jemel, A, Ben Mrad, M, Kallel, S, Derbel, B, Gueldiche, M, Ghédira, F, Mlaïhi, S, Masmoudi, S, Kalfat, T, Menif, J, Ben Omrane, S, Karoui, A, Khayati, A
• Format: Journal Article
• Language: French
• Published: France 01.02.2013
• Subjects: Accidents, Traffic; Adolescent; Adult; Aorta, Thoracic - injuries; Aorta, Thoracic - surgery; Aortic Rupture - complications; Aortic Rupture - diagnostic imaging; Aortic Rupture - mortality; Aortic Rupture - surgery; Aortography; Blood Transfusion - utilization; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - methods; Blood Vessel Prosthesis Implantation - utilization; Decision Trees; Disease Management; Disseminated Intravascular Coagulation - etiology; Disseminated Intravascular Coagulation - mortality; Endovascular Procedures - methods; Endovascular Procedures - utilization; Female; Humans; Intraoperative Complications - mortality; Male; Middle Aged; Multiple Trauma - complications; Postoperative Complications - mortality; Retrospective Studies; Shock, Hemorrhagic - etiology; Shock, Hemorrhagic - mortality; Shock, Hemorrhagic - therapy; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
• ISSN: 2214-8116

The aim of this study was to review our experience in the management of traumatic rupture of the aortic isthmus, to evaluate the results of surgery and endovascular exclusion and to develop an adequate therapeutic strategy based on the existence and severity of associated injuries. A series of 37 patients presenting posttraumatic aortic rupture associated with other severe lesions was collected from 2000 to 2012. There were 33 males and four females, mean age 38 years. In this series, 25 patients underwent surgical treatment and 12 endovascular exclusion. Six patients died during or after surgery. Overall mortality was 16% (24% in the surgery group). The postoperative period was uneventful in all patients treated with the endovascular procedure. Postoperative computed tomography controls at one week, 1 month and 12 months showed good positioning of the stent without endoleakage. Traumatic aortic rupture is often the result of a severe high-energy chest trauma. Other serious injuries are often associated. Results of immediate surgical repair are associated with high morbidity and mortality. The advent of endovascular treatment has revolutionized the treatment of traumatic aortic rupture, especially in patients with a high surgical risk.