| Summary: | The current recommendation is immediate surgical treatment of acute traumatic transection (ATT) of the aorta. Open surgical repair carries high morbidity and mortality. Endovascular repair (TEVAR) has emerged as a safer option. The timing of intervention remains a matter of debate We review our outcomes of delayed endovascular repair of ATT.
Methods: From 2011 to 2013, 7 patients underwent delayed TEVAR for ATT. All patients had their records reviewed retrospectively regarding mechanism of injury, concomitant injuries, technical details, post-operative complications and long term follow up.
Results: The mean age was 30.29 years (range 24–51 years) and 6 out of 7 patients were male. The mechanism of injury was motor vehicle collision in 6 patients. The median time from injury to TEVAR was 8.7 days and there was no mortality during this period. Technical success was 100%. None of the patients suffered any neurological events, arrhythmias, acute renal injury, distal ischemia or endoleak. The median hospital stay was 10 days and all patients were discharged home with no hospital mortality. Mean follow up was 12 months and all patients were alive at follow up and none required re-intervention.
Conclusion: The delayed approach has been safe with no patients lost during the waiting period. Patients with ATT who make it to the hospital and are stable from the aortic point of view may be managed safely with delayed TEVAR if immediate therapy is not available or possible.
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