Abstract：Objective To investigate feasibility and validity of endovascular aortic repair (EVAR) of traumatic thoracic aortic injuries (TTAI). Methods A retrospective analysis was conducted on data of 13 patients with TTAI. Pathological changes were evaluated by spinal CT angiography (CTA) preoperatively and reevaluated by digital subtraction angiography (DSA) in EVAR. CTA was performed again to confirm therapeutic effects at postoperative 3, 6, 12 months and annually thereafter. Results All patients had successful EVAR. Complete or partial cover of left subclavian artery was observed in four patients. Endoleak in angiography shortly after stent delivery was noticed in three patients. However, endoleak disappeared in one patient after short stent placement for twice; endoleak was evidently decreased in one patient after balloon dilation. Follow-up was performed for another patient with slight endoleak. A total of 12 patients were followed up, which showed no complications, such as endoleak, ischemia of left upper extremity, paralysis or stentgraft migration. Conclusion EVR is safe and effective in treatment of TTAI.
［1］Scaglione M, Pinto A, Pinto F, et al. Role of contrast-enhanced helical CT in the evaluation of acute thoracic aortic injuries after blunt chest trauma. Eur Radiol, 2001, 11（12）:2444-2448.
［2］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（4）:760-777.
［3］Richens D, Field M, Neale M, et al. The mechanism of injury in blunt traumatic rupture of the aorta. Eur J Cardiothorac Surg, 2002, 21（2）:288-293.
［4］Williams JS, Graft JA, Uku JM, et al. Aortic injury in vehicular trauma. Ann Thorac Surg, 1994, 57（3）:726-730.
［5］Creasy JD, Chiles C, Routh WD, et al. Overview of traumatic injury of the thoracic aorta. Radio Graphics, 1997, 17（1）:27-45.
［6］Lomoschitz FM, Eisenhuber E, Linnau KF, et al. Imaging of chest trauma: radiological patterns of injury and diagnostic algorithms. Eur J Rodiol, 2003, 48（1）:61-70.
［7］Hoffer EK. Endovascular intervention in thoracic arterial trauma.Injury, 2008, 39（11）:1257-1274.
［8］Gammie JS, Shab AS, Hattler BG, et al. Traumatic aortic rupture: diagnosis and management. Ann Thorac Surg, 1998, 66（4）:1295-1300.
［9］Macura KJ, Corl FM, Fishman EK, et al. Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. Am J Roentgenol, 2003, 181（2）:309-316.
［13］von Oppell UO, Dunne TT, De Groot MK, et al. Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia. Ann Thorac Surg, 1994, 58(2):585-593.
［14］Cheng D, Martin J, Shennib H, et al. Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease a systematic review and meta-analysis of comparative studies. J Am Coll Cardiol, 2010, 55(10):986-1001.
［15］Xenos ES, Abedi NN, Davenport DL, et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg, 2008, 48(5):1343-1351.
［16］Tang GL, Tehrani HY, Usman A, et al. Reduced mortality, paraplegia, and stroke with stent graft repair of blunt aortic transactions: a modern meta-analysis. J Vase Surg, 2008, 47(3):671-675.
［17］Mustafa ST, Sadat U, Majeed MU, et al. Endovascular repair of nonruptured thoracic aortic aneurysms: systematic review. Vascular, 2010, 18(1):28-33.
