Objective To explore the mid-term follow-up results of thoracic endovascular aortic repair (TEVAR) for Grade 3 blunt thoracic aortic injuries (BTAI), and analyze the postoperative aortic dilatation based on the imaging of computed tomographic angiography (CTA).

Methods A total of 28 consecutive Grade 3 BTAI in patients treated with TEVAR in Zhongshan Hospital, Fudan University between July 2008 and June 2015. Trauma-related pseudoaneurysms and dissections were categorized into Grade 3 BTAI, mean follow-up time was 5.5 months. Endpoints were survival, reintervention, stent graft (SG)-related complications, and postoperative aortic remodeling and dilatation. The pre-operative and post-operative aorta diameters of different aspects were also recorded and compared.

Results Among 28 patients, 25 pseudoaneurysms and 3 dissections were recruited. There were 19 males and 9 females, the average age was (47.0±13.7) years old. All patients underwent delayed TEVAR with a median of 8 days after trauma. One patient died of pulmonary embolism 1 week after TEVAR. The technical success rate of TEVAR was 100.0%(28/28) and clinical success rate was 96.4%(27/28). Twenty-seven patients survived and were followed up. During this period, no stroke or endoleak occurred. No reintervention was performed although 14 SG-related complications (including 12 bird-beak configurations and 4 stenotic or occluded LSA) were observed. Aortic dilation was observed in ascending aorta at the bifurcation of pulmonary artery, descending aorta at the bifurcation of pulmonary artery, aortic bifurcation, but there was no significant difference between pre-operation and post-operation. Moreover, there was no correlation between aortic dilation and complications.

Conclusions TEVAR is safe and effective for thoracic aortic pseudoaneurysm and aortic dissection induced by BTAI.