Journal of Vascular and Interventional Radiology
Volume 19, Issue 8 , Pages 1153-1164 , August 2008

Endovascular Stent-Graft or Open Surgical Repair for Blunt Thoracic Aortic Trauma: Systematic Review

Received 7 November 2007 ,Revised 10 May 2008 ,Accepted 18 May 2008.

References 

  1. Bergen G, Chen LH, Warner M, Fingerhut LA. Injury in the United States: 2007 Chartbook. Hyattsville, Maryland: National Center for Health Statistics; 2008;
  2. National Center for Health Statistics. Health, United States, 2007. Hyattsville, Maryland: National Center for Health Statistics; 2007;
  3. Attar S, Cardarelli MG, Downing SW, et al. Traumatic aortic rupture: recent outcome with regard to neurologic deficit. Ann Thorac Surg. 1999;67:959–964
  4. Jamieson WR, Janusz MT, Gudas VM, Burr LH, Fradet GJ, Henderson C. Traumatic rupture of the thoracic aorta: third decade of experience. Am J Surg. 2002;183:571–575
  5. Razzouk AJ, Gundry SR, Wang N, del Rio MJ, Varnell D, Bailey LL. Repair of traumatic aortic rupture: a 25-year experience. Arch Surg. 2000;135:913–918
  6. Cook J, Salerno C, Krishnadasan B, Nicholls S, Meissner M, Karmy-Jones R. The effect of changing presentation and management on the outcome of blunt rupture of the thoracic aorta. J Thorac Cardiovasc Surg. 2006;131:594–600
  7. Cardarelli MG, McLaughlin JS, Downing SW, Brown JM, Attar S, Griffith BP. Management of traumatic aortic rupture: a 30-year experience. Ann Surg. 2002;236:465–469
  8. Michetti CP, Hanna R, Crandall JR, Fakhry SM. Contemporary analysis of thoracic aortic injury: importance of screening based on crash characteristics. J Trauma. 2007;63:18–24
  9. Siegel JH, Smith JA, Siddiqi SQ. Change in velocity and energy dissipation on impact in motor vehicle crashes as a function of the direction of crash: key factors in the production of thoracic aortic injuries, their pattern of associated injuries and patient survival: a Crash Injury Research Engineering Network (CIREN) study. J Trauma. 2004;57:760–777
  10. Parmley LF, Manion WC, Mattingly TW. Nonpenetrating traumatic injury of the heart. Circulation. 1958;18:371–396
  11. Fabian TC, Richardson JD, Croce MA, et al. Prospective study of blunt aortic injury: multicenter trial of the American Association for the Surgery of Trauma. J Trauma. 1997;42:374–380
  12. von Oppell UO, Dunne TT, De Groot MK, Zilla P. Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia. Ann Thorac Surg. 1994;58:585–593
  13. Mirvis SE, Shanmuganathan K, Miller BH, White CS, Turney SZ. Traumatic aortic injury: diagnosis with contrast-enhanced thoracic CT–five-year experience at a major trauma center. Radiology. 1996;200:413–422
  14. Jahromi AS, Kazemi K, Safar HA, Doobay B, Cina CS. Traumatic rupture of the thoracic aorta: cohort study and systematic review. J Vasc Surg. 2001;34:1029–1034
  15. Hochheiser GM, Clark DE, Morton JR. Operative technique, paraplegia, and mortality after blunt traumatic aortic injury. Arch Surg. 2002;137:434–438
  16. Pate JW, Gavant ML, Weiman DS, Fabian TC. Traumatic rupture of the aortic isthmus: program of selective management. World J Surg. 1999;23:59–63
  17. McGwin G, Reiff DA, Moran SG, Rue LW. Incidence and characteristics of motor vehicle collision-related blunt thoracic aortic injury according to age. J Trauma. 2002;52:859–865
  18. Reed AB, Thompson JK, Crafton CJ, Delvecchio C, Giglia JS. Timing of endovascular repair of blunt traumatic thoracic aortic transections. J Vasc Surg. 2006;43:684–688
  19. Camp PC, Rogers FB, Shackford SR, Leavitt BJ, Cobean RA, Clark DE. Blunt traumatic thoracic aortic lacerations in the elderly: an analysis of outcome. J Trauma. 1994;37:418–423
  20. Hirose H, Gill IS, Malangoni MA. Nonoperative management of traumatic aortic injury. J Trauma. 2006;60:597–601
  21. Hunt JP, Baker CC, Lentz CW, et al. Thoracic aorta injuries: management and outcome of 144 patients. J Trauma. 1996;40:547–555
  22. Stampfl P, Greitbauer M, Zimpfer D, et al. Mid-term results of conservative, conventional and endovascular treatment for acute traumatic aortic lesions. Eur J Vasc Endovasc Surg. 2006;31:475–480
  23. Kwon CC, Gill IS, Fallon WF, et al. Delayed operative intervention in the management of traumatic descending thoracic aortic rupture. Ann Thorac Surg. 2002;74(suppl):S1888–S1891
  24. Gammie JS, Shah AS, Hattler BG, et al. Traumatic aortic rupture: diagnosis and management. Ann Thorac Surg. 1998;66:1295–1300
  25. Cowley RA, Turney SZ, Hankins JR, Rodriguez A, Attar S, Shankar BS. Rupture of thoracic aorta caused by blunt trauma: a fifteen-year experience. J Thorac Cardiovasc Surg. 1990;100:652–660
  26. Volodos NL, Karpovich IP, Troyan VI, et al. Clinical experience of the use of self-fixing synthetic prostheses for remote endoprosthetics of the thoracic and the abdominal aorta and iliac arteries through the femoral artery and as intraoperative endoprosthesis for aorta reconstruction. Vasa Suppl. 1991;33:93–95
  27. Dake MD, Miller DC, Mitchell RS, Semba CP, Moore KA, Sakai T. The “first generation” of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta. J Thorac Cardiovasc Surg. 1998;116:689–703
  28. Williams DM, Andrews JC, Chee SS, Marx MV, Abrams GD. Canine model of acute aortic rupture: treatment with percutaneous delivery of a covered Z stent–work in progress. J Vasc Interv Radiol. 1994;5:797–803
  29. Doss M, Balzer J, Martens S, et al. Surgical versus endovascular treatment of acute thoracic aortic rupture: a single-center experience. Ann Thorac Surg. 2003;76:1465–1469
  30. Kasirajan K, Heffernan D, Langsfeld M. Acute thoracic aortic trauma: a comparison of endoluminal stent grafts with open repair and nonoperative management. Ann Vasc Surg. 2003;17:589–595
  31. Amabile P, Collart F, Gariboldi V, Rollet G, Bartoli JM, Piquet P. Surgical versus endovascular treatment of traumatic thoracic aortic rupture. J Vasc Surg. 2004;40:873–879
  32. Ott MC, Stewart TC, Lawlor DK, Gray DK, Forbes TL. Management of blunt thoracic aortic injuries: endovascular stents versus open repair. J Trauma. 2004;56:565–570
  33. Pacini D, Angeli E, Fattori R, et al. Traumatic rupture of the thoracic aorta: ten years of delayed management. J Thorac Cardiovasc Surg. 2005;129:880–884
  34. Rousseau H, Dambrin C, Marcheix B, et al. Acute traumatic aortic rupture: a comparison of surgical and stent-graft repair. J Thorac Cardiovasc Surg. 2005;129:1050–1055
  35. Kuhne CA, Ruchholtz S, Voggenreiter G, et al. Traumatic aortic injuries in severely injured patients. Unfallchirurg. 2005;108:279–287
  36. Lebl DR, Dicker RA, Spain DA, Brundage SI. Dramatic shift in the primary management of traumatic thoracic aortic rupture. Arch Surg. 2006;141:177–180
  37. Broux C, Thony F, Chavanon O, et al. Emergency endovascular stent graft repair for acute blunt thoracic aortic injury: a retrospective case control study. Intens Care Med. 2006;32:770–774
  38. Andrassy J, Weidenhagen R, Meimarakis G, Lauterjung L, Jauch KW, Kopp R. Stent versus open surgery for acute and chronic traumatic injury of the thoracic aorta: a single-center experience. J Trauma. 2006;60:765–771
  39. Kurimoto Y, Morishita K, Kawaharada N, et al. Initial experiences in management of blunt aortic injury taking associated brain injury into consideration. Circ J. 2006;70:198–201
  40. Midgley PI, Mackenzie KS, Corriveau MM, et al. Blunt thoracic aortic injury: A single institution comparison of open and endovascular management. J Vasc Surg. 2007;46:662–668
  41. McPhee JT, Asham EH, Rohrer MJ, et al. The midterm results of stent graft treatment of thoracic aortic injuries. J Surg Res. 2007;138:181–188
  42. Buz S, Zipfel B, Mulahasanovic S, Pasic M, Weng Y, Hetzer R. Conventional surgical repair and endovascular treatment of acute traumatic aortic rupture. Eur J Cardiothorac Surg. 2008;33:149–149
  43. Kokotsakis J, Kaskarelis I, Misthos P, et al. Endovascular versus open repair for blunt thoracic aortic injury: short-term results. Ann Thorac Surg. 2007;84:1965–1970
  44. Riesenman PJ, Farber MA, Rich PB, et al. Outcomes of surgical and endovascular treatment of acute traumatic thoracic aortic injury. J Vasc Surg. 2007;46:934–940
  45. Chung J, Owen R, Turnbull R, Chyczij H, Winkelaar G, Gibney N. Endovascular repair in traumatic thoracic aortic injuries: comparison with open surgical repair. J Vasc Interv Radiol. 2008;19:479–486
  46. Fujikawa T, Yukioka T, Ishimaru S, et al. Endovascular stent grafting for the treatment of blunt thoracic aortic injury. J Trauma. 2001;50:223–229
  47. Bortone AS, Schena S, D'Agostino D, et al. Immediate versus delayed endovascular treatment of post-traumatic aortic pseudoaneurysms and type B dissections: retrospective analysis and premises to the upcoming European trial. Circulation. 2002;106:I234–I240
  48. Orford VP, Atkinson NR, Thomson K, et al. Blunt traumatic aortic transection: the endovascular experience. Ann Thorac Surg. 2003;75:106–111
  49. Marty-Ane CH, Berthet JP, Branchereau P, Mary H, Alric P. Endovascular repair for acute traumatic rupture of the thoracic aorta. Ann Thorac Surg. 2003;75:1803–1807
  50. Dunham MB, Zygun D, Petrasek P, Kortbeek JB, Karmy-Jones R, Moore RD. Endovascular stent grafts for acute blunt aortic injury. J Trauma. 2004;56:1173–1178
  51. Kato M, Yatsu S, Sato H, Kyo S. Endovascular stent-graft treatment for blunt aortic injury. Circ J. 2004;68:553–557
  52. Leurs LJ, Bell R, Degrieck Y, et al. Endovascular treatment of thoracic aortic diseases: combined experience from the EUROSTAR and United Kingdom thoracic endograft registries. J Vasc Surg. 2004;40:670–679
  53. Melnitchouk S, Pfammatter T, Kadner A, et al. Emergency stent-graft placement for hemorrhage control in acute thoracic aortic rupture. Eur J Cardiothorac Surg. 2004;25:1032–1038
  54. Scheinert D, Krankenberg H, Schmidt A, et al. Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta. Eur Heart J. 2004;25:694–700
  55. Wellons ED, Milner R, Solis M, Levitt A, Rosenthal D. Stent-graft repair of traumatic thoracic aortic disruptions. J Vasc Surg. 2004;40:1095–1100
  56. Agostinelli A, Saccani S, Borrello B, Nicolini F, Larini P, Gherli T. Immediate endovascular treatment of blunt aortic injury: our therapeutic strategy. J Thorac Cardiovasc Surg. 2006;131:1053–1057
  57. Caronno R, Piffaretti G, Tozzi M, et al. Emergency endovascular stent-graft treatment for acute thoracic aortic syndromes. Surgery. 2006;140:58–65
  58. Ferrari E, Tozzi P, von Segesser L. Thoracic aorta emergencies: is the endovascular treatment the new gold standard?. Interact Cardiovasc Thorac Surg. 2006;5:730–734
  59. Hoornweg LL, Dinkelman MK, Goslings JC, et al. Endovascular management of traumatic ruptures of the thoracic aorta: a retrospective multicenter analysis of 28 cases in The Netherlands. J Vasc Surg. 2006;43:1096–1102
  60. Kwok PC, Ho KK, Ma CC, et al. The short-to-midterm results of endovascular stent grafting for acute thoracic aortic diseases in Chinese patients. Hong Kong Med J. 2006;12:355–360
  61. Pratesi C, Dorigo W, Troisi N, et al. Acute traumatic rupture of the descending thoracic aorta: endovascular treatment. Am J Surg. 2006;192:291–295
  62. Tehrani HY, Peterson BG, Katariya K, et al. Endovascular repair of thoracic aortic tears. Ann Thorac Surg. 2006;82:873–877
  63. Veeraswamy RK, Sanchez LA, Rubin BG, et al. Endovascular repair of thoracic aortic lesions using infrarenal devices: lessons learned and continued applications. Ann Vasc Surg. 2006;20:330–337
  64. Attia C, Villard J, Boussel L, et al. Endovascular repair of localized pathological lesions of the descending thoracic aorta: midterm results. Cardiovasc Intervent Radiol. 2007;30:628–637
  65. Livi U, Piccoli G, Ciccarese G, et al. Stent-grafting of the thoracic aorta: feasibility and early results in acute and chronic lesions. J Cardiovasc Med (Hagerstown). 2007;8:504–510
  66. Neschis DG, Moaine S, Gutta R, et al. Twenty consecutive cases of endograft repair of traumatic aortic disruption: lessons learned. J Vasc Surg. 2007;45:487–492
  67. Orend KH, Zarbis N, Schelzig H, Halter G, Lang G, Sunder-Plassmann L. Endovascular treatment (EVT) of acute traumatic lesions of the descending thoracic aorta—7 years' experience. Eur J Vasc Endovasc Surg. 2007;34:666–672
  68. Raupach J, Ferko A, Lojik M, Krajina A, Harrer J, Dominik J. Endovascular treatment of acute and chronic thoracic aortic injury. Cardiovasc Intervent Radiol. 2007;30:1117–1123
  69. Rodriguez JA, Olsen DM, Shtutman A, et al. Application of endograft to treat thoracic aortic pathologies: a single center experience. J Vasc Surg. 2007;46:413–420
  70. Saratzis NA, Saratzis AN, Melas N, et al. Endovascular repair of traumatic rupture of the thoracic aorta: single-center experience. Cardiovasc Intervent Radiol. 2007;30:370–375
  71. Steingruber IE, Czermak BV, Chemelli A, et al. Placement of endovascular stent-grafts for emergency repair of acute traumatic aortic rupture: a single-centre experience. Eur Radiol. 2007;17:1727–1737
  72. Tespili M, Banfi C, Valsecchi O, et al. Endovascular treatment of thoracic aortic disease: mid-term follow-up. Cathet Cardiovasc Interv. 2007;70:595–601
  73. Thompson M, Ivaz S, Cheshire N, et al. Early results of endovascular treatment of the thoracic aorta using the Valiant endograft. Cardiovasc Intervent Radiol. 2007;30:1130–1138
  74. Go MR, Barbato JE, Dillavou ED, et al. Thoracic endovascular aortic repair for traumatic aortic transection. J Vasc Surg. 2007;46:928–933
  75. Bent CL, Matson MB, Sobeh M, et al. Endovascular management of acute blunt traumatic thoracic aortic injury: a single center experience. J Vasc Surg. 2007;46:920–927
  76. Chaikof EL, Blankensteijn JD, Harris PL, et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1048–1060
  77. The Nordic Cochrane Center. Review Manager (RevMan), version 4.2 [product manual]. Copenhagen: The Nordic Cochrane Center; 2005;
  78. Symbas PN, Sherman AJ, Silver JM, Symbas JD, Lackey JJ. Traumatic rupture of the aorta: immediate or delayed repair?. Ann Surg. 2002;235:796–802
  79. Santaniello JM, Miller PR, Croce MA, et al. Blunt aortic injury with concomitant intra-abdominal solid organ injury: treatment priorities revisited. J Trauma. 2002;53:442–445
  80. Morishita K, Kurimoto Y, Kawaharada N, et al. Descending thoracic aortic rupture: role of endovascular stent-grafting. Ann Thorac Surg. 2004;78:1630–1634
  81. Fattori R, Napoli G, Lovato L, et al. Indications for, timing of, and results of catheter-based treatment of traumatic injury to the aorta. AJR Am J Roentgenol. 2002;179:603–609
  82. Marcheix B, Dambrin C, Bolduc JP, et al. Endovascular repair of traumatic rupture of the aortic isthmus: midterm results. J Thorac Cardiovasc Surg. 2006;132:1037–1041
  83. Lawlor DK, Ott M, Forbes TL, Kribs S, Harris KA, DeRose G. Endovascular management of traumatic thoracic aortic injuries. Can J Surg. 2005;48:293–297
  84. Orend KH, Pamler R, Kapfer X, Liewald F, Gorich J, Sunder-Plassmann L. Endovascular repair of traumatic descending aortic transection. J Endovasc Ther. 2002;9:573–578
  85. Bortone AS, De Cillis E, D'Agostino D, de Luca Tupputi Schinosa L. Endovascular treatment of thoracic aortic disease: four years of experience. Circulation. 2004;110:II262–II267
  86. Eddy AC, Rusch VW, Marchioro T, Ashbaugh D, Verrier ED, Dillard D. Treatment of traumatic rupture of the thoracic aorta: a 15-year experience. Arch Surg. 1990;125:1351–1355
  87. Kirsh MM, Behrendt DM, Orringer MB, et al. The treatment of acute traumatic rupture of the aorta: a 10-year experience. Ann Surg. 1976;184:308–316
  88. Wahl WL, Michaels AJ, Wang SC, Dries DJ, Taheri PA. Blunt thoracic aortic injury: delayed or early repair?. J Trauma. 1999;47:254–249
  89. Borsa JJ, Hoffer EK, Karmy-Jones R, et al. Angiographic description of blunt traumatic injuries to the thoracic aorta with specific relevance to endograft repair. J Endovasc Ther. 2002;9(suppl 2):II84–II91
  90. Hoffer EK, Karmy-Jones R, Bloch RD, et al. Treatment of acute thoracic aortic injury with commercially available abdominal aortic stent-grafts. J Vasc Interv Radiol. 2002;13:1037–1041
  91. Lachat M, Pfammatter T, Witzke H, et al. Acute traumatic aortic rupture: early stent-graft repair. Eur J Cardiothorac Surg. 2002;21:959–963
  92. Czermak BV, Waldenberger P, Perkmann R, et al. Placement of endovascular stent-grafts for emergency treatment of acute disease of the descending thoracic aorta. AJR Am J Roentgenol. 2002;179:337–345
  93. Gorich J, Asquan Y, Seifarth H, et al. Initial experience with intentional stent-graft coverage of the subclavian artery during endovascular thoracic aortic repairs. J Endovasc Ther. 2002;9(suppl 2):II39–II43
  94. Rehders TC, Petzsch M, Ince H, et al. Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta: risk and relevance. J Endovasc Ther. 2004;11:659–666
  95. Orend KH, Scharrer-Pamler R, Kapfer X, Kotsis T, Gorich J, Sunder-Plassmann L. Endovascular treatment in diseases of the descending thoracic aorta: 6-year results of a single center. J Vasc Surg. 2003;37:91–99
  96. Tay KY, U-King-Im JM, Trivedi RA, et al. Imaging the vertebral artery. Eur Radiol. 2005;15:1329–1343
  97. Vorster W, du Plooy PT, Meiring JH. Abnormal origin of internal thoracic and vertebral arteries. Clin Anat. 1998;11:33–37
  98. Steinbauer MG, Stehr A, Pfister K, et al. Endovascular repair of proximal endograft collapse after treatment for thoracic aortic disease. J Vasc Surg. 2006;43:609–612
  99. W.L. Gore and Associates. Gore TAG thoracic endoprosthesis [instructions for use]. http://www.goremedical.com/en/ifu/AJ0076.pdf2006;Accessed October 31, 2007
  100. Karmy-Jones R, Hoffer E, Meissner MH, Nicholls S, Mattos M. Endovascular stent grafts and aortic rupture: a case series. J Trauma. 2003;55:805–810
  101. Makaroun MS, Dillavou ED, Kee ST, et al. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the Gore TAG thoracic endoprosthesis. J Vasc Surg. 2005;41:1–9
  102. Greenberg RK, O'Neill S, Walker E, et al. Endovascular repair of thoracic aortic lesions with the Zenith TX1 and TX2 thoracic grafts: intermediate-term results. J Vasc Surg. 2005;41:589–596
  103. Fattori R, Nienaber CA, Rousseau H, et al. Results of endovascular repair of the thoracic aorta with the Talent thoracic stent graft: the Talent Thoracic Retrospective Registry. J Thorac Cardiovasc Surg. 2006;132:332–339
  104. Karmy-Jones R, Hoffer E, Meissner M, Bloch RD. Management of traumatic rupture of the thoracic aorta in pediatric patients. Ann Thorac Surg. 2003;75:1513–1517

 None of the authors have identified a conflict of interest.

PII: S1051-0443(08)00506-X

doi: 10.1016/j.jvir.2008.05.012

Journal of Vascular and Interventional Radiology
Volume 19, Issue 8 , Pages 1153-1164 , August 2008

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