Thoracic endovascular aortic repair of blunt traumatic thoracic aorta injury: A propensity score-matched analysis of the long-term clinical outcome

Abstract Objectives: Patients of blunt traumatic thoracic aortic injury (BTAI) have different vessel property with those of primary type B aortic dissection (pATBAD). We hypothesize that thoracic endovascular aortic repair (TEVAR) may have better efficacy for BTAI patients than for pATBAD. This study aimed to compare the outcome of TEVAR for these two populations based on a prospectively built clinical database. Methods: To reduce the baseline characteristic disparity between two groups, propensity score analysis with a match of 1:2 ratio was employed in BTAI and pATBAD patients who underwent TEVAR in a tertiary center from 2009 to 2018. Data including demographic, perioperative and follow up results were retrieved and analysed.Results: A total of 41 BTAI and 82 pATBAD patients were enrolled. Baseline characteristics were comparable between both groups after match. The pATBAD group had a remarkably higher incidence of hypertension (p < 0.001). The total stent-graft covered length was significantly longer in the pATBAD group than in the BTAI group (p = 0.016). Aortic-related reintervention rate was significantly higher in the pATBAD group than in the BTAI group (p = 0.027). Higher rate of abdominal complete FL thrombosis was achieved in BTAI group than in pATBAD group (69.2% vs. 28.6%, p = 0.001).Overall, the early outcomes and long-term survival were similar in both groups. Conclusions: TEVAR for BTAI patients show the acceptable clinical efficacy and safety when compared with the pATBAD. This study could provide more solid evidence for current clinical practice to support TEVAR for BTAI.