Joseph Giglia, MD, interim director of the University of Cincinatti’s division of vascular surgery estimates that 80 to 90 percent of the patients who suffer this injury – known as blunt thoracic aortic trauma – die before ever reaching a hospital.
A severe blunt thoracic accident, usually a non-penetrating “deceleration” injury, can jerk the aorta forward and back again, causing it to crack. If all three layers of the aorta rupture immediately, the patient will die almost instantly from blood loss. If the outer layer remains intact, however, a weakened area called a pseudoaneurysm can form, which often bursts later. Surgeons must repair the damaged aorta quickly before it does rupture, killing the patient.
Dr. Giglia’s team found that by placing a standard surgical stent in the aorta and lining it with a series of small synthetic grafts called endografts, they could effectively protect the damaged area without stopping blood flow to the rest of the body.
The endografts are regularly used in vascular surgery to treat aneurysms in the abdomen, Dr. Giglia explains, but they are too short to fully bridge the damaged area in the chest.
“Used alone, extender cuffs are hard to align and often slip into the defect to cause further complications,” says Dr. Giglia. “Using a fixed stent provides an easy-to-see ‘scaffolding’ that can guide the surgeon to more accurately secure the extender cuffs and create a strong seal.”
Once in place, the dual lining supports the weakened vessel walls and allows blood to continue flowing through the aorta without applying pressure to damaged area.
Standard “open” treatment for this type of injury can work, says Dr. Giglia, but it puts significant stress on the patient’s heart and brain and increases the risk for heart attack, bleeding, paraplegia and other problems.
MEDICA.de; Source: University of Cincinatti