Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.200074
Jornal Vascular Brasileiro
Original Article

Tratamento endovascular de dissecção traumática de aorta torácica – série de 16 casos

Endovascular treatment of traumatic dissection of the thoracic aorta – series of 16 cases

Lucas Mansano Sarquis; Wilson Michaelis; Antonio Lacerda Santos Filho; Cristiano Silva Pinto; Rogerio Akira Yokoyama; Erick Fernando Seguro; Antonio Luiz da Costa Martins; Vinicius Belas do Vale

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Resumo

Resumo: Contexto: As lesões de aorta nos traumatismos torácicos fechados possuem alta mortalidade pré-hospitalar e no serviço de emergência. O tratamento endovascular é um método de escolha para o tratamento dessas lesões; entretanto, muitos resultados em relação a essa abordagem permanecem desconhecidos.

Objetivos: O objetivo deste trabalho é descrever a experiência no tratamento endovascular de lesões traumáticas de aorta torácica em um centro de referência em trauma.

Métodos: Este trabalho trata-se de estudo descritivo realizado através da revisão de prontuários eletrônicos de pacientes vítimas de trauma contuso de aorta torácica, atendidos em um hospital de referência em trauma na cidade de Curitiba (Paraná, Brasil).

Resultados: Dezesseis pacientes foram incluídos no estudo. Todos os pacientes foram vítimas de acidente de trânsito, sendo que 75% dos acidentes ocorreram por colisão entre veículos. As lesões de aorta variaram de Grau I a IV, e a maioria dos pacientes apresentou lesão de grau II (50%). Todos os pacientes foram submetidos a terapia endovascular com implante de endoprótese sendo realizado em média 71 horas após o trauma. Dois pacientes evoluíram a óbito, porém de causas não relacionadas à lesão de aorta. Durante o seguimento, apenas dois pacientes apresentaram complicações (endoleak e progressão da dissecção).

Conclusões: O método endovascular é uma alternativa viável no tratamento de lesões de aorta torácica por trauma contuso. São necessários estudos randomizados e controlados a fim de reforçar a indicação desse método como terapia para esse tipo de lesão.

Palavras-chave

aorta torácica, lesões, doenças da aorta, procedimentos endovasculares

Abstract

Background: Aortic injuries caused by blunt chest traumas have high pre-hospital and emergency mortality. The endovascular approach is one option for treatment of these injuries, but many outcomes related to this approach remain unknown. Objectives: The aim of this study is to describe a specialist trauma center’s experience with endovascular treatment of cases like these. Methods: This is a descriptive study based on review of the electronic medical records of patients who had suffered from blunt thoracic aorta trauma and were seen at a hospital specializing in trauma cases in the city of Curitiba (Paraná, Brazil). Results: Sixteen patients were included in the study. All patients were traffic accident victims and 75% of the accidents were the result of vehicle collisions. Aortic lesions ranged from grade I to IV and the majority had grade II lesions (50%). All patients underwent endovascular treatment with endografts, an average of 71 hours after the trauma. Two patients died, both from causes unrelated to their aortic injuries. During follow-up, only two patients presented complications (endoleak and progression of the dissection). Conclusions: The endovascular method is a viable alternative for treatment of blunt trauma thoracic aortic injuries. Randomized and controlled studies are needed to provide evidence to support indication of this method to treat this type of injury.

Keywords

thoracic aorta; wounds; aortic diseases; endovascular procedures.

References

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Submitted date:
05/27/2020

Accepted date:
08/06/2020

5faecbe00e8825c226134908 jvb Articles

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