Management of Post-Traumatic Aortic Isthmus Ruptures

The purpose of this study is to review our experience in the management of post-traumatic aortic isthmus rupture, to evaluate the outcomes of surgical and endovascular exclusion procedures, and to develop an appropriate treatment strategy based on the presence and severity of associated injuries. From 2000 to 2012, 37 patients were enrolled (33 men and 4 women) with a mean age of 38 years who presented with a post-traumatic rupture of the aortic isthmus as part of multiple trauma, with life-threatening associated injuries in 86.5% of cases. Twenty-five patients underwent surgical treatment. Twelve patients underwent endovascular exclusion. Six patients died during or following the procedure, resulting in an overall mortality rate of 16%; this rate was 24% in the group of patients who underwent aortic surgery and 0% in the endovascular group. Morbidity in the surgical group was dominated by one case of stroke. In the endovascular group, postoperative complications were minor.