Document Detail


Improved outcomes with endovascular stent grafts for thoracic aorta transections.
MedLine Citation:
PMID:  18474443     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To retrospectively assess the outcome of endovascular stent-graft implantation for thoracic aortic transections (ETAT). DESIGN: Retrospective review. METHODS: 16 patients median age 30 years, treated between May 2000 and April 2007. Median injury severity score was 33 (range 29 to 66) in 14 acute patients; 2 patients had thoracic pseudoaneurysms. The Cook-Zenith endograft was used in eight patients, Medtronic-Talent (6) and Gore-Excluder (2). Average procedure time was 90 minutes, blood loss 100 (range 40 to 3000) mls, screening time 10.8 (range 5.9 to 22.6) minutes, and contrast dose was 195 (range 60 to 400) mls. RESULTS: Graft deployment was successful in all cases. There was one death within 30 days. The left subclavian artery was completely covered in one case, and partially in three. Two patients had Type I endoleak, and one delayed Type II endoleak. One patient had iatrogenic right coronary artery dissection. Two patients developed difficult to treat hypertension, and one acute renal failure. CONCLUSION: Endovascular intervention is a safe and effective treatment for aortic transection in multiple trauma patients. ETAT reduces the major morbidity and mortality associated with open repair in multiple trauma patients. The majority of these patients are young and long-term follow up is necessary to assess graft durability.
Authors:
I V Mohan; K Hitos; G H White; J P Harris; M S Stephen; J May; J Swinnen; J P Fletcher
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-05-13
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  36     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-14     Completed Date:  2008-08-14     Revised Date:  2008-12-29    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  152-7     Citation Subset:  IM    
Affiliation:
Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, Australia. irwin.mohan@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aneurysm, False / mortality,  radiography,  surgery*
Aorta, Thoracic / injuries*,  radiography,  surgery*
Aortic Aneurysm, Thoracic / mortality,  radiography,  surgery*
Aortic Rupture / mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Female
Humans
Male
Middle Aged
New South Wales / epidemiology
Retrospective Studies
Severity of Illness Index
Stents*
Tomography, X-Ray Computed
Treatment Outcome
Comments/Corrections
Comment In:
Eur J Vasc Endovasc Surg. 2009 Jan;37(1):120; author reply 120-1   [PMID:  19008130 ]
Eur J Vasc Endovasc Surg. 2008 Aug;36(2):158-9   [PMID:  18524641 ]

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


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