Vascular surgery.

VOL. 53 NO. 1 MARCH 2015 SAJS 19 Recent reports suggest that endovascular ther apy is safe and effective for the treatment of pseudo­ aneurysms caused by blunt traumatic aorta injury (BTAI).[1­6] Although the numbers of patients in these reports are small, technical success approaches 100% and procedure­related mortality and complications are reported to be low.[1,2,5,7,8] This is compared with the perioperative mortality of open surgery, which is reported to be 15 ­ 71% and is influenced by the haemodynamic stability of the patient and the severity of coexisting injuries.[2­4,6,9] Thoracic endovascular aortic repair (TEVAR) is therefore preferred in trauma centres where appropriate facilities and expertise exist. However, this complex procedure often has to be performed as an emergency in unstable patients with challenging anatomy. TEVAR­ related complications may affect mortality and morbidity. The objective of this study was to evaluate the limitations and potential adverse effects related to the endovascular management of pseudoaneurysms due to BTAI.