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Eur J Cardiothorac Surg 2001;19:739-745
© 2001 Elsevier Science NL

Endovascular treatment of acute bleeding complications in traumatic aortic rupture and aortobronchial fistula

^a Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes-Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany
^b Department of Radiology, University Hospital, Johannes-Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany

Received 22 November 2000; received in revised form 21 March 2001; accepted 22 March 2001.

Corresponding author. Tel.: +49-6131-173208; fax: +49-6131-173626
e-mail: dorweiler{at}htg.klinik.uni-mainz.de

Objective: Herein we report our experience in placement of endovascular stentgrafts in the descending aorta in patients with acute bleeding complications due to traumatic rupture or aortobronchial fistula. Methods: Six patients (one woman, five men, mean age 47±19 years) were treated from September 1995 to February 2000 by implantation of endovascular stentgrafts in the descending aorta. Indications included traumatic ruptures of the aortic isthmus (n=3) and aortobronchial fistulas (n=3). All procedures were performed under general anaesthesia. The implants were introduced under fluoroscopic guidance via the aorta (n=1), the iliac (n=4) or femoral (n=2) artery, respectively. Results: All aortobronchial fistulas and ruptures were sealed up successfully. There was no perioperative morbidity and no procedure-related morbidity except one patient who received aortofemoral reconstruction because of iliac occlusive disease. All patients are alive and well after a mean follow-up of 31 months (range 6–60). Two patients had recurrent hemoptysis, in one case, the patient received a second implant (distal extension), the other patient was managed conservatively. Conclusion: Endovascular treatment by a stentgraft is a safe and reliable procedure in the management of acute bleeding complications in patients with aortic rupture or aortobronchial fistulas.

Key Words: Traumatic aortic rupture • Aortobronchial fistula • Endovascular treatment

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