Outcomes of endovascular repair of acute thoracic aortic injury: interrogation of the New Zealand thoracic aortic stent database (NZ TAS).

OBJECTIVES: Report the New Zealand national experience of endovascular repair of acute traumatic thoracic aortic injuries (TTAIs).

DESIGN: Retrospective analysis of the New Zealand thoracic aortic stent database between December 2001 and December 2007.

MATERIALS AND METHODS: Of the 134 patients on the database, 27 patients (20%) underwent endovascular repair of TTAI. Data collected included age, sex, cause of injury, details of the procedure, complications and mortality.

RESULTS: Most patients were young, median age 20 (15-78), male (n=19, 70%), and involved in motor vehicle accidents (n=23, 85%). Median length of aorta stented was 117 mm (77-200 mm). Great vessel origins were covered intentionally in 23 (85%) patients, four (17%) requiring a hybrid procedure. Average procedure time was 98.3 min (35-180). Primary technical success was 96%, secondary technical success 100%. Endoleaks were observed in four (15%) patients, one requiring a second endovascular procedure. There were no conversions to open surgery. Procedure-related complications occurred in four (15%) patients. No patient developed cord injury. All cause mortality at 30 days is one (4%) and at discharge is two (7%) due to associated poly-trauma.

CONCLUSION: Our results add further evidence of the safety of endovascular repair of thoracic aortic injury and compare favourably with those of other centres.