[Traumatic injuries of the thoracic aorta-Role of interventional radiology].

Acute aortic injuries are among the most life-threatening emergencies in vascular and emergency medicine. They are mostly caused by high-velocity trauma with deceleration and shear forces in the region of the aortic isthmus. Due to the anatomical features these particularly result in tears or complete transection of the vascular wall. Without rapid diagnosis and treatment the majority of cases are fatal. Contrast-enhanced computed tomography (CT) angiography is considered the diagnostic gold standard and enables a precise classification of the injury according to the severity and immediate treatment planning. Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for lesion grades II and III. The interdisciplinary interplay of interventional radiology, cardiovascular surgery and anesthesia can achieve a significant reduction in the perioperative mortality. Although mortality rates of up to 20% have been reported after open surgery, the mortality after TEVAR is between 7% and 9%. Neurological complications, particularly spinal ischemia, are less common than after open surgical treatment. Following successful TEVAR a life-long imaging follow-up is necessary for the early detection of prosthesis migration, endoleaks or infections.