Thoracic endovascular repair in management of traumatic aortic dissection. A 10 years experience

Background: Results of surgery in descending aortic dissection is usually not safe. Recently after introducing the thoracic endovascular stents the outcome marvelously improved. Our objective was to evaluate the results of our 10 years experience of using the endovascular stents in trauma patients.Methods: In Saudi German Hospital in Madinah Munawarah, from 2007 to 2016 13, cases of traumatic aortic dissection were subjected to thoracic endovascular aortic repair (TEVAR). All cases were victims of blunt trauma in road traffic accidents (RTAs). All had descending thoracic aortic dissection just after the left subclavian artery. Medtronic TEVAR was used in all cases. The data of those patients were collected and revised. CT angio, echocardiography and abdominal ultrasonography were the main tools in the diagnosis.Results: All cases were males, middle aged, victims of RTAs and all were associated with other injuries.12 cases survived, one died due to major head injury. The survived cases had no paraplegia either before or after stenting. No intra-thoracic bleeding occurred after the procedure. All cases had no coronary artery or valvular involvement. All cases had good landing zones most were within the range of 2 cms or even more. There was no mortality or morbidity related to the procedure.Conclusions: The TEVAR is a reliable, safe, convenient and with less complications than the surgical management for traumatic aortic dissection. No incidence of paraplegia was encountered. It is mandatory in all cases presented in RTAs to be surveyed for traumatic aortic dissection