Endovascular repair of blunt traumatic thoracic aortic injuries: seven-year single-center experience.

Division of Vascular Surgery, Northwestern University, 676 N St Clair, Chicago, IL 60611, USA.
Archives of surgery (Chicago, Ill.: 1960) (Impact Factor: 4.3). 07/2010; 145(7):679-83. DOI: 10.1001/archsurg.2010.114
Source: PubMed

ABSTRACT Thoracic endovascular aortic repair (TEVAR) for acute blunt thoracic aortic injury has good early and mid-term results.
Single-center retrospective 7-year review from January 2001 to December 2008.
Urban tertiary care hospital.
Twenty-four consecutive patients with acute blunt thoracic aortic injury treated with TEVAR.
Procedure-related mortality, stroke, or paraplegia; injury severity score; and complications.
Among the 24 treated patients (mean age, 41 years; range, 20-71 years), the mean injury severity score was 43 (range, 25-66). Thoracic endovascular aortic repair was successful in treating the aortic injury in all patients and there were no instances of procedure-related death, stroke, or paraplegia. Access to the aorta was obtained through an open femoral/iliac approach (n = 7) or an entirely percutaneous groin approach (n = 17). Systemic heparin was not used in 84% of cases. Two access complications (8%) occurred, requiring an iliofemoral bypass in one patient and a thrombectomy in another. One patient required secondary intervention for device collapse, which was treated successfully with repeat endografting. There have been no delayed device failures or complications among the entire cohort at mid-term follow-up.
Thoracic endovascular aortic repair, via a percutaneous groin approach and without systemic anticoagulation, for blunt thoracic aortic injury can be performed safely with low periprocedural mortality and morbidity.

  • [Show abstract] [Hide abstract]
    ABSTRACT: We present our experience of endovascular surgery for traumatic aortic injury and the results of our procedures.
    Annals of Vascular Diseases 01/2014; 7(3):300-5. DOI:10.3400/avd.oa.14-00051
  • Circulation 04/2015; 131(14):1291-9. DOI:10.1161/CIRCULATIONAHA.114.006512 · 14.95 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To report the results of long-term (>5 years) computed tomography (CT) angiography follow-up after thoracic endovascular aortic repair in patients with traumatic thoracic aortic injury. All follow-up CT angiographies performed in patients with traumatic thoracic aorta injury treated by endovascular stent-graft between 2002 and 2008 were reviewed. Of the 14 patients treated, seven patients had CT angiography follow-up examinations for more than 5 years. All patients were men with a mean age of 26 years. The Talent device was used in four patients and Gore TAG device in three patients. The mean device diameter and length were 24.6 mm and 103 mm, respectively. Follow-up included annual outpatient clinic surveillance and CT angiography examinations, which were reviewed for any device-related complications. The radiation effective dose was calculated from the CT dose report. Thirty-three CT examinations performed 64-110 months (mean 76) after stent-graft implementation were reviewed. The mean follow-up number of examinations per patient was 4.7 (range 2-8). Intra-graft circular mural tissue at the distal part of the stent-graft was seen in one patient. Stable lack of proximal device apposition was seen in all patients. No other radiological complications (e.g., aortic infection, dilatation, aneurysm or pseudoaneurysm, device struts breakage, migration, collapse, endoleak) were detected. None of the patients developed hypertension. The average effective dose was 77.01 mSv (range 34.11-128.84 mSv). CT angiography did not reveal any complications developing throughout the long-term follow-up. These results suggest that long-term CT angiography follow-up may not be required.
    Clinical Radiology 02/2014; 69(5). DOI:10.1016/j.crad.2013.12.013 · 1.66 Impact Factor