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Endovascular repair of thoracic aortic tears
Journal article   Open access   Peer reviewed

Endovascular repair of thoracic aortic tears

Hassan Y Tehrani, Brian G Peterson, Kushagra Katariya, Mark D Morasch, Randy Stevens, Gabrielle DiLuozzo, Tomas Salerno, Giuseppe Maurici, Darwin Eton and Mark K Eskandari
The Annals of thoracic surgery, v 82(3), pp 873-878
01 Sep 2006
DOI: https://doi.org/10.1016/j.athoracsur.2006.04.012
PMID: 16928500
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.athoracsur.2006.04.012View
Published, Version of Record (VoR) Open

Abstract

Accidents, Traffic Adult Aged Aged, 80 and over Aorta, Thoracic - injuries Aorta, Thoracic - surgery Emergencies Female Fluoroscopy Follow-Up Studies Humans Lacerations - surgery Male Middle Aged Multiple Trauma Postoperative Complications - epidemiology Radiography, Interventional Retrospective Studies Stents Vascular Surgical Procedures - instrumentation Wounds, Nonpenetrating - surgery
Standard treatment of traumatic thoracic aortic transection (TTAT) is open repair by left thoracotomy with or without the use of partial cardiopulmonary bypass. However, open repair is associated with high rates of morbidity and mortality, particularly in multiply injured trauma patients. We reviewed our experiences of endovascular repair of acute TTAT. Between February 2001 and February 2006, 30 patients (male 24, female 6, mean age 43 years) who had sustained severe blunt trauma with multiple injuries (mean injury severity score = 42) underwent endovascular repair for TTAT. Devices used included commercially available proximal abdominal aortic extension cuffs and thoracic stent-grafts. Either low dose or no systemic heparin was used. Arterial access was obtained by femoral-iliac cutdown (n = 19) or completely percutaneous through the femoral artery (n = 11). Mean follow-up was 11.6 months (range, 1 to 48 months). Technically success was achieved in 100% of patients, as determined by angiographic and computed tomographic (CT) scan exclusion of TTAT. Mean operating time was 132 minutes. Mean blood loss was 300 cm3. Three patients had complications: 1 iliac artery rupture, 1 cerebellar stroke, and 1 partial stent collapse. There were 2 perioperative deaths. There were no instances of procedure-related paralysis. Clinical and CT follow-up did not reveal evidence of endoleak, stent migration, or late pseudoaneurysm formation. The adaptation of commercially available stent-graft devices to treat TTAT is technically feasible, and can be performed with low rates of morbidity and mortality. The long-term durability of endovascular repair of TTAT remains unknown, but early and midterm results appear promising.

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96 citations in Web of Science
115 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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