Document Detail


Endovascular versus open repair for blunt thoracic aortic injury: short-term results.
MedLine Citation:
PMID:  18036917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Endovascular stent grafting has been increasingly used as an alternative treatment modality. The aim of this study is to evaluate the immediate and short-term results of endovascular stent grafting repair after blunt thoracic aortic injury due to trauma. METHODS: A review of a tertiary trauma center registry identified all patients who suffered blunt thoracic aortic injury from 2002 to 2006. All patients underwent either open repair with synthetic graft interposition or endovascular stent grafting (EVS) of the descending thoracic aorta. Type and severity of injury, concomitant injuries, clinical factors, and outcome were compared between groups. Univariate and multivariate analysis was performed. RESULTS: Endovascular stent grafting was performed in 22 patients, and 10 patients underwent open surgical repair. In the open group, the 30-day mortality rate was 10%, the paraplegia rate was 10%, and incidence of major complications was 30%, which were comparable with the incidences observed in the EVS group of 4.5%, 4.5%, and 13.6%, respectively. No statistically significant differences were demonstrated. Multivariate regression analysis identified associated thoracic injury as the main independent predictor of hospital length of stay (p = 0.03, 95% confidence interval: 0.53 to 18.85). In the EVS group, 1 patient died in the short-term follow-up period and 2 cases of endovascular leak required additional treatment. CONCLUSIONS: Although postoperative mortality and morbidity between open and endovascular repair were comparable, EVS can be considered a safe alternative treatment modality in the therapeutic algorithm of blunt thoracic aortic injury particularly for the higher risk multitrauma patients.
Authors:
John Kokotsakis; Ioannis Kaskarelis; Panagiotis Misthos; Thanos Athanasiou; Konstantinos Kanakakis; Chariklia Athanasiou; Constantina Romana; Elian Skouteli; Achilles Lioulias
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  84     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-26     Completed Date:  2007-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1965-70     Citation Subset:  AIM; IM    
Affiliation:
Second Cardiac Surgical Department, Evangelismos General Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aorta, Thoracic / injuries*,  surgery*
Blood Vessel Prosthesis Implantation / methods*
Female
Humans
Length of Stay
Male
Middle Aged
Multivariate Analysis
Postoperative Complications / epidemiology
Regression Analysis
Stents*
Wounds, Nonpenetrating / surgery*

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


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