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Background <p>This study aimed to summarize a 12-year single-center experience with Grade III blunt thoracic aortic injury (BTAI) and to evaluate the outcomes of early versus delayed thoracic endovascular aortic repair (TEVAR) in the context of real-world clinical decision-making, with the goal of providing further insight into how optimal surgical timing may be individualized based on patient presentation and clinical stability.</p> Methods <p>A retrospective analysis was conducted on 53 patients with Grade III BTAI treated between August 2011 and January 2024. Based on clinical condition, patients were categorized into early TEVAR (&lt; 24&#xa0;h) and delayed TEVAR (&gt; 24&#xa0;h) groups. Perioperative and follow-up outcomes were assessed.</p> Results <p>Among the 53 patients, 16 underwent early TEVAR and 37 underwent delayed TEVAR. The median age was 54.00 (IQR 37.00-59.50) years, and 77.4% were male. Motor vehicle collisions were the leading cause of injury (60.4%). Common associated injuries included fractures (94.3%), pulmonary injuries (62.3%), and cranial injuries (41.5%). The early TEVAR group had significantly higher Injury Severity Score (ISS), a higher proportion of shock index &gt; 1, and higher rates of emergency surgery (all <i>p</i> &lt; 0.01). There were no significant differences in perioperative mortality or endoleak rates between the two groups. No patients experienced paraplegia, cardiovascular events, or renal impairment. Aortic-related length of stay was shorter in the early TEVAR group (<i>p</i> &lt; 0.001), which also had a higher rate of post-TEVAR surgery for associated injuries (<i>p</i> = 0.006). During follow-up, no significant differences were observed in all-cause mortality or aortic-related reintervention rates between groups. No aortic-related deaths occurred in either group.</p> Conclusion <p>Delayed TEVAR may be safe and feasible in selected patients with Grade III BTAI, but retrospective design limits direct comparison with early intervention. Treatment decisions and timing of TEVAR should be individualized.</p>

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Timing of TEVAR in grade III blunt traumatic aortic injury: a 12-year single-center retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Qi Qin,
  • Lun-Chang Wang,
  • Quan-Ming Li,
  • Ming Li,
  • Hao He,
  • Xin Li,
  • Chang Shu

摘要

Background

This study aimed to summarize a 12-year single-center experience with Grade III blunt thoracic aortic injury (BTAI) and to evaluate the outcomes of early versus delayed thoracic endovascular aortic repair (TEVAR) in the context of real-world clinical decision-making, with the goal of providing further insight into how optimal surgical timing may be individualized based on patient presentation and clinical stability.

Methods

A retrospective analysis was conducted on 53 patients with Grade III BTAI treated between August 2011 and January 2024. Based on clinical condition, patients were categorized into early TEVAR (< 24 h) and delayed TEVAR (> 24 h) groups. Perioperative and follow-up outcomes were assessed.

Results

Among the 53 patients, 16 underwent early TEVAR and 37 underwent delayed TEVAR. The median age was 54.00 (IQR 37.00-59.50) years, and 77.4% were male. Motor vehicle collisions were the leading cause of injury (60.4%). Common associated injuries included fractures (94.3%), pulmonary injuries (62.3%), and cranial injuries (41.5%). The early TEVAR group had significantly higher Injury Severity Score (ISS), a higher proportion of shock index > 1, and higher rates of emergency surgery (all p < 0.01). There were no significant differences in perioperative mortality or endoleak rates between the two groups. No patients experienced paraplegia, cardiovascular events, or renal impairment. Aortic-related length of stay was shorter in the early TEVAR group (p < 0.001), which also had a higher rate of post-TEVAR surgery for associated injuries (p = 0.006). During follow-up, no significant differences were observed in all-cause mortality or aortic-related reintervention rates between groups. No aortic-related deaths occurred in either group.

Conclusion

Delayed TEVAR may be safe and feasible in selected patients with Grade III BTAI, but retrospective design limits direct comparison with early intervention. Treatment decisions and timing of TEVAR should be individualized.