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Endovascular management of traumatic infrarenal abdominal aortic dissection.

Abstract：

:Dissection is a recognized finding after blunt trauma to the abdominal aorta. Immediate and long-term prognosis is poor without surgical treatment especially since most patients present severe associated injuries. On the basis of encouraging results using endovascular techniques to treat experimental dissection of the descending thoracic aorta, we treated three patients with traumatic infrarenal abdominal aortic dissection by percutaneous stent placement. There were two men 34 and 41 years of age and one 89-year-old woman. In all patients, dissection began in the infrarenal portion of the aorta and extended into the iliac arteries. All patients had multiple associated injuries. The main symptoms were acute abdominal pain (two patients) and ischemia of the lower extremities (two patients). Diagnosis was missed in one patient despite exploratory laparotomy for an associated injury. Two patients were treated in the acute phase by placement of a self-expanding endovascular prosthesis at the aortoiliac level. The third patient was treated in the chronic phase by placement of a balloon-expandable endovascular stent. All procedures were performed uneventfully by femoral route. Success of treatment was confirmed by arteriography and computed tomography (CT) scan demonstrating obliteration of the dissection. Upon late follow-up examination, all patients were in satisfactory condition, with normal Doppler ultrasound findings. These findings confirm experimental studies using endovascular treatment for dissection of the descending thoracic aorta and are promising for future clinical management.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Picard E,Marty-Ané CH,Vernhet H,Sessa C,Lesnik A,Senac JP,Mary H

doi

10.1007/s100169900194

subject

Has Abstract

pub_date

1998-11-01 00:00:00

pages

515-21

issue

6

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(06)61695-6

journal_volume

12

pub_type

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