E-Science Station

Blunt trauma aortic injury (BTAI) is still a life-threatening surgical emergency (85% died at the scene, 30% died in 6 hours and 49% died in 24 hours if scene survival. All trauma patients with high-risk deceleration injuries undergoes routine helical CT evaluation of mediastinum irrespective of CXR. finding. Endovascular therapy replaced operative repair now.

Retrospective review of prospective study described pathological characteristic, indications, technique, early and midterm of Endovascular Therapy for BTAI in Viet Duc Hospital from 2012 to 2019. All patients had regular clinical and CT-Scanner after 1 month and every 6 months.

28 patients (26 males and 2 females) with mean age 38(range 19-74) were treated with endovascular therapy between March 2012 and May 2019. Including: 3 cases grade II, 20 grade III and 5 cases grade IV of BTAI. There were 21 cases emergency, and 6 cases elective. The locations separate: Ascending Aorta: 1, Arch: 5, Isthmus: 13, Descending Aorta: 6 and Abdominal Aorta: 3 patients. We’ve had 1 patient in medical treatment, 18 patients were done TEVAR, 5 patients needed Hybrid procedures, 2 cases of EVAR and we performed OR for 2 patients. Deployment success was 100%, with no endoleak on completion angiogram. The 30-day mortality after procedure was 6% (2 cases: 1^stseptic shock,2^ndperitonitis). No patient had bleeding or coagulopathy, no endoleak, migration or collapse and no second intervention or conventional surgery. The mean follow-up 12 months (range 1-24).

Routine CT screening is suspicious mechanism of injury has now become a standard. TEVAR has replaced open repair for BTAI. We still need more long-term result after endovascular repair.