Endovascular repair in acute traumatic aortic transection: a case report

A thirty-eight year old, male patient who suffered from 10th and 11th thoracal vertebrae fractures, paraplegia and acute traumatic aortic transection because of accidental fall was referred to our hospital. Open surgical repair had a very high risk due to severe coexisting injuries. Transection was treated with 30x100 mm Vailant thoracic endograft which was deployed just distal to the ostium of the left carotid artery. Patient was transfered to neurosurgery clinic for treatment of paraplegia after uneventful recovery. Endovascular repair of acute transection confers substantial advantages in mortality and morbidity according to surgical repair. But the long-term durability of thoracic endografts is still unknown. If the long-term results are satisfactory just like promising mid-term results, this technique may become a gold standart approach for treatment of acute transection.

Akut travmatik aort transeksiyonunda endovasküler tamir: olgu sunumu

Yüksekten düþme sonucu 10 ve 11. torakal vertebralarda burst fraktürü, parapleji ve akut aort transeksiyonu saptanan otuzsekiz yaþýndaki erkek hasta, transeksiyon tedavisi amacýyla merkezimize sevk edildi. Eþlik eden ciddi yaralanmalar nedeniyle cerrahi tamir yüksek riskli bulundu. Transeksiyon endovasküler yöntemle, 30X100 mm Vailant torasik endogreft, sol karotis arter ostiyumunun hemen distaline yerleþtirilerek tamir edildi. Hasta olaðan seyreden servis takibinin ardýndan nöroþirurji servisine, parapleji tedavisinin devamý amacýyla geri gönderildi. Akut transeksiyon tedavisinde endovasküler yöntemler cerrahi tamire oranla morbidite ve mortalitede önemli avantajlar saðlamaktadýr. Ancak torasik endogreftlerin uzun dönem sonuçlarý halen bilinmemektedir. Orta dönemde elde edilen umut verici neticeler uzun dönemde de saðlanabilirse, endovasküler tamir altýn standart haline gelebilir.