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Traumatic thoracic aortic aneurysm: treatment with endovascular stent-grafts.
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1997
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Traumatic aortic aneurysms were classified as acute in three patients and chronic in seven. The study aimed to demonstrate the feasibility and safety of endovascular stent‑graft placement for treating traumatic aortic aneurysm in ten patients. Stent‑grafts, made from modified Z‑stents covered with woven polyester or expanded polytetrafluoroethylene, were deployed via a 20‑24‑F delivery sheath in a remote artery, achieving successful placement and aneurysmal sac thrombosis in all cases. All patients survived with no complications during a mean 15‑month follow‑up, though three experienced major complications that required interventions such as coil embolization, subclavian artery transposition, and bronchial stenting, underscoring the procedure’s feasibility as an alternative to open‑chest surgery.
To demonstrate the feasibility and safety of endovascular stent-graft placement for treatment of traumatic aortic aneurysm.Ten patients with traumatic aortic aneurysm were treated with endovascular stent-grafts. Three patients had an acute traumatic aneurysm; seven had a chronic aneurysm. Stent-grafts were constructed from modified Z-stents covered with woven polyester or expanded polytetrafluoroethylene graft material and were deployed through a 20-24-F delivery sheath in an exposed artery located remotely from the lesion.Stent-graft placement and thrombosis of the aneurysmal sac were successful in all patients. Major complications were encountered in three patients after endovascular treatment. One patient had a peri-graft leak; complete thrombosis of the aneurysmal sac was achieved after coil embolization of the leak. Transposition of the left subclavian artery was necessary to relieve left arm ischemia in another patient. In the third patient, stent placement in the left main stem bronchus was needed to relieve left lung atelectasis. All patients were alive and without complications during the follow-up period (mean, 15 months).Transluminal placement of endovascular stent-grafts is a technically feasible method for treatment of traumatic thoracic aortic aneurysm and may be an effective alternative to open-chest surgery.