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Ann Thorac Surg. 2014 Mar;97(3):774-80. doi: 10.1016/j.athoracsur.2013.09.034. Epub 2013 Nov 22.

Endovascular repair of traumatic thoracic aortic injury: final results from the relay endovascular registry for thoracic disease.

Author information

1
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany. Electronic address: zipfel@dhzb.de.
2
Department of Vascular Surgery, IRCCS, San Raffaele, Milan, Italy.
3
Department of Radiology, Hôpital de Rangueil, Toulouse, France.
4
Department of Vascular Surgery, Evangelismos Hospital, Athens, Greece.
5
Department of Vascular Surgery, Hospital Clínic, Barcelona, Spain.
6
Department of Vascular Surgery, Policlinico di Modena, Italy.
7
Department of Diagnostic and Interventional Radiology, Ospedale San Martino, Italy.
8
Department of Cardiothoracic and Vascular Surgery, Ospedale Le Scotte, Siena, Italy.
9
Department of Vascular Surgery, Hospital Germans Trias I Pujol, Barcelona, Spain.
10
Department of Vascular Surgery, ACO, San Filippo Neri, Rome, Italy.
11
Department of Vascular Surgery, IRCCS, Policlinico San Donato, Milan, Italy.
12
Department of Cardiovascular and Interventional Radiology, Allgemeines Krankenhaus, Vienna, Austria.
13
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany.

Abstract

BACKGROUND:

In blunt thoracic aortic injury, thoracic endovascular aortic repair (TEVAR) offers a less invasive alternative to open chest surgery. New reliable and accurate stent grafts have widened the endovascular treatment options. We report our experience with the Relay stent graft Bolton Medical, Sunrise, FL; Barcelona, Spain) for treatment of this injury.

METHODS:

Relay Endovascular Registry for Thoracic Disease (RESTORE) is a multicenter, prospective European registry, which enrolled patients treated with the Relay stent graft for thoracic aortic diseases from April 2005 to January 2009. Regular follow-up examinations were conducted for up to 24 months. This paper analyzes the cohort of patients treated for traumatic aortic injury.

RESULTS:

Forty adult trauma patients from 12 European centers underwent TEVAR. Mean age was 40 years and 34 patients were male. The proximal landing zone involved aortic arch zones 1 to 2 in 40% and zone 3 in 55% of procedures. Technical success was achieved in all cases. One (2.5%) patient suffered a rupture of the iliac artery. No patient developed procedure-related paraplegia or required conversion to open surgery. Follow-up imaging demonstrated complete exclusion of the traumatic tear and regression of the false aneurysms without endoleak or graft infolding. One late device-related complication was reported; penetration of the distal end of the stent graft treated by stent-graft extension. Thirty-day mortality was 2.5 % (n = 1), and late mortality 2.5% due to a secondary accident. Actuarial 2-year survival was 93.7%.

CONCLUSIONS:

Thoracic endovascular aortic repair with the Relay stent graft is a safe and effective treatment for patients with traumatic aortic injury.

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