Document Detail


Endovascular treatment of traumatic thoracic aortic injuries: short- and medium-term Follow-up.
MedLine Citation:
PMID:  19900782     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Successful thoracic endovascular aortic repair (TEVAR) with low rates of complications has been referred to in the treatment of traumatic thoracic aortic injuries; however, we still do not know the long-term behavior. In this series, short- and intermediate-term results of TEVAR of traumatic aortic injuries are analyzed. METHODS: The clinical charts and courses of 20 patients (mean age, 31.8 years; age range, 15-65 years; 14 [70%] men) with traumatic thoracic aortic injuries treated with TEVAR were retrospectively reviewed. Mean delay from trauma to intervention was 15 days (range, 0-180 days). RESULTS: The initial success rate was 100%, with no deaths or intraoperative leaks, although in 4 (20%) patients, injuries were repaired in the arterial access site. The mean postoperative follow-up was 43.53 months (range, 5.5-108.0 months). Four (20%) patients required reintervention: 2 postoperative revascularizations of the left subclavian artery (20% of the patients in whom the ostium was intentionally occluded) and 2 aortic reinterventions (endovascular treatment of a collapsed stent graft and open repair after thrombosis of another stent graft). All reinterventions were successfully performed and no additional complications were registered during follow-up. Asymptomatic findings related to the stent graft included lack of proximal device-wall apposition in 8 patients (40%), intragraft mural thrombus formation during the first 6 months in 7 patients (35%), and an asymptomatic fracture of the longitudinal reinforcing bar of the stent graft 4 years later in 1 patient (5%). CONCLUSION: Although not completely exempt of complications, TEVAR provides a reliable method for the treatment of traumatic thoracic aortic injuries with good results in the short- and medium-term follow-up. All complications have been treated successfully. Long-term evolution of lack of proximal device-wall apposition and intragraft mural thrombus formation should be closely monitored to prevent long-term complications.
Authors:
Valent?n Fernandez; Gaspar Mestres; Jordi Maeso; Jos? Manuel Dom?nguez; M Carmen Aloy; Manel Matas
Publication Detail:
Type:  Journal Article     Date:  2009-11-08
Journal Detail:
Title:  Annals of vascular surgery     Volume:  24     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  160-6     Citation Subset:  IM    
Copyright Information:
Copyright 2006 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aorta, Thoracic / injuries*,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation
Female
Humans
Male
Middle Aged
Prosthesis Failure
Reoperation
Retrospective Studies
Stents
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Wounds and Injuries / radiography,  surgery*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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