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Asian Cardiovasc Thorac Ann 2008;16:337-345
© 2008 Asia Publishing EXchange Ltd

REVIEW PAPER

Endovascular Repair of Traumatic Thoracic Aortic Injuries: a Critical Appraisal

Peter H Lin, MD1,3, Tam T Huynh, MD1,3, Panagiotis Kougias, MD1,3, Mathew J Wall, Jr, MD2,5, Joseph S Coselli, MD2,4, Kenneth L Mattox, MD2,5

1 Division of Vascular Surgery & Endovascular Therapy
2 Division of Cardiothoracic Surgery Michael E DeBakey Department of Surgery Baylor College of Medicine
3 Michael E DeBakey VA Medical Center
4 Texas Heart Institute at St. Luke’s Episcopal Hospital
5 Ben Taub General Hospital Houston, USA

For reprint information contact: Peter H Lin, MD, Tel: 1 713 794 7895, Email: plin{at}bcm.edu, Michael E DeBakey, Department of Surgery, Baylor College of Medicine, Houston VAMC (112), 2002 Holcomb Blvd, Houston, TX 77030, USA.

Blunt trauma to the thoracic aorta is life-threatening, with instant fatality in at least 75% of victims. If left untreated, nearly half of those who survive the initial injury will die within the first 24 hours. Surgical repair has been the standard treatment of blunt aortic injury, but immediate operative intervention is frequently difficult due to concomitant injuries. Although endovascular treatment of traumatic aortic disruption is less invasive than conventional repair via thoracotomy, this strategy remains controversial in young patients due to anatomical considerations and device limitations. This article reviews the likely advantages of endovascular interventions for blunt thoracic aortic injuries. Potential limitations and clinical outcomes of this minimally invasive technique are also discussed.






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