Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 6/2019

01-12-2019 | Original Article

Mid-term outcomes of endovascular repair for traumatic thoracic aortic injury: a single-center experience

Authors: Shin-Ah Son, Hanna Jung, Joon Yong Cho, Tak-Hyuk Oh, Young Woo Do, Kyoung Hoon Lim, Gun-Jik Kim

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2019

Login to get access

Abstract

Purpose

Thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury (TTAI) reports short-term benefits. However, long-term durability and the need of reintervention remain unclear. Here, we determined mid-term outcome of TEVAR for TTAI and investigated the influence of the length of proximal landing zone on aorta.

Methods

Between October 2009 and February 2018, 69 patients diagnosed TTAI and 42 included patients underwent TEVAR. Patients were divided into two groups by the length of proximal landing zone; ≤ 20 mm and > 20 mm. The primary endpoint was success and survival rate, and the secondary endpoint was the increase of aorta size and the need of reintervention.

Results

The mean follow-up period was 47.9 ± 29.6 months and 100% success rate. No endoleaks or additional reinterventions during the follow-up period. The cumulative survival of all-cause death was 90.5 ± 2.3%, 85.7 ± 4.1% and 61.7 ± 8.4% at 1, 5 and 7 years, respectively. There was no statistically significant difference in the increase of aorta size due to the length of the proximal landing zone (p = 0.65).

Conclusion

In selective TTAI patients for TEVAR, the length of proximal landing zone did not considerably influence the aorta size or needed further reintervention.
Literature
1.
Fabian TC, Richardson JD, Croce MA, Smith JS Jr, Rodman G Jr, Kearney PA, et al. Prospective study of blunt aortic injury: multicenter trial of the American Association for the surgery of trauma. J Trauma. 1997;42(3):374–80 (discussion 80-3).CrossRef
2.
Dake MD, Miller DC, Semba CP, Mitchell RS, Walker PJ, Liddell RP. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med. 1994;331(26):1729–34.CrossRef
3.
Borsa JJ, Hoffer EK, Karmy-Jones R, Fontaine AB, Bloch RD, Yoon JK, et al. Angiographic description of blunt traumatic injuries to the thoracic aorta with specific relevance to endograft repair. J Endovasc Ther. 2002;9(Suppl 2):II84–91.CrossRef
4.
Brinster DR. Endovascular repair of blunt thoracic aortic injuries. Semin Thorac Cardiovasc Surg. 2009;21(4):393–8.CrossRef
5.
Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–96.CrossRef
6.
Mitchell RS, Ishimaru S, Ehrlich MP, Iwase T, Lauterjung L, Shimono T, et al. First International Summit on thoracic aortic endografting: roundtable on thoracic aortic dissection as an indication for endografting. J Endovasc Ther. 2002;9(Suppl 2):98–105.CrossRef
7.
Azizzadeh A, Keyhani K, Miller CC 3rd, Coogan SM, Safi HJ, Estrera AL. Blunt traumatic aortic injury: initial experience with endovascular repair. J Vasc Surg. 2009;49(6):1403–8.CrossRef
8.
Fillinger MF, Greenberg RK, McKinsey JF, Chaikof EL, Society for Vascular Surgery Ad Hoc Committee on TRS. Reporting standards for thoracic endovascular aortic repair (TEVAR). J Vasc Surg. 2010;52(4):1022–33 (33 e15).CrossRef
9.
Steuer J, Wanhainen A, Thelin S, Nyman R, Eriksson MO, Bjorck M. Outcome of endovascular treatment of traumatic aortic transection. J Vasc Surg. 2012;56(4):973–8.CrossRef
10.
Clancy TV, Gary Maxwell J, Covington DL, Brinker CC, Blackman D. A statewide analysis of level I and II trauma centers for patients with major injuries. J Trauma. 2001;51(2):346–51.CrossRef
11.
Ungar TC, Wolf SJ, Haukoos JS, Dyer DS, Moore EE. Derivation of a clinical decision rule to exclude thoracic aortic imaging in patients with blunt chest trauma after motor vehicle collisions. J Trauma. 2006;61(5):1150–5.CrossRef
12.
Pretre R, Chilcott M. Blunt trauma to the heart and great vessels. N Engl J Med. 1997;336(9):626–32.CrossRef
13.
Neschis DG, Scalea TM, Flinn WR, Griffith BP. Blunt aortic injury. N Engl J Med. 2008;359(16):1708–16.CrossRef
14.
Zhang L, Zhao Z, Chen Y, Sun Y, Bao J, Jing Z, et al. Reintervention after endovascular repair for aortic dissection: a systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2016;152(5):1279–88 (e3).CrossRef
15.
Peterson BG, Matsumura JS, Morasch MD, West MA, Eskandari MK. Percutaneous endovascular repair of blunt thoracic aortic transection. J Trauma. 2005;59(5):1062–5.CrossRef
16.
Fattori R, Russo V, Lovato L, Di Bartolomeo R. Optimal management of traumatic aortic injury. Eur J Vasc Endovasc Surg. 2009;37(1):8–14.CrossRef
17.
Lachat M, Pfammatter T, Witzke H, Bernard E, Wolfensberger U, Kunzli A, et al. Acute traumatic aortic rupture: early stent-graft repair. Eur J Cardiothorac Surg. 2002;21(6):959–63.CrossRef
18.
Ehrlich MP, Rousseau H, Heijman R, Piquet P, Beregi JP, Nienaber CA, et al. Early outcome of endovascular treatment of acute traumatic aortic injuries: the talent thoracic retrospective registry. Ann Thorac Surg. 2009;88(4):1258–63.CrossRef
19.
Coady MA, Ikonomidis JS, Cheung AT, Matsumoto AH, Dake MD, Chaikof EL, et al. Surgical management of descending thoracic aortic disease: open and endovascular approaches: a scientific statement from the American Heart Association. Circulation. 2010;121(25):2780–804.CrossRef
20.
Garcia Reyes ME, Goncalves Martins G, Fernandez Valenzuela V, Dominguez Gonzalez JM, Maeso Lebrun J, Bellmunt Montoya S. Long-term outcomes of thoracic endovascular aortic repair focused on bird beak and oversizing in blunt traumatic thoracic aortic injury. Ann Vasc Surg. 2018;50:140–7.CrossRef
21.
Alberta HB, Takayama T, Smits TC, Wendorff BB, Cambria RP, Farber MA, et al. Aortic arch morphology and aortic length in patients with dissection, traumatic, and aneurysmal disease. Eur J Vasc Endovasc Surg. 2015;50(6):754–60.CrossRef
22.
Kasirajan K, Dake MD, Lumsden A, Bavaria J, Makaroun MS. Incidence and outcomes after infolding or collapse of thoracic stent grafts. J Vasc Surg. 2012;55(3):652–8 (discussion 8).CrossRef
23.
Spiliotopoulos K, Kokotsakis J, Argiriou M, Dedeilias P, Farsaris D, Diamantis T, et al. Endovascular repair for blunt thoracic aortic injury: 11-year outcomes and postoperative surveillance experience. J Thorac Cardiovasc Surg. 2014;148(6):2956–61.CrossRef
24.
Azizzadeh A, Ray HM, Dubose JJ, Charlton-Ouw KM, Miller CC, Coogan SM, et al. Outcomes of endovascular repair for patients with blunt traumatic aortic injury. J Trauma Acute Care Surg. 2014;76(2):510–6.CrossRef
25.
McBride CL, Dubose JJ, Miller CC 3rd, Perlick AP, Charlton-Ouw KM, Estrera AL, et al. Intentional left subclavian artery coverage during thoracic endovascular aortic repair for traumatic aortic injury. J Vasc Surg. 2015;61(1):73–9.CrossRef
26.
Antonello M, Menegolo M, Maturi C, Dall’antonia A, Lepidi S, Frigo AC, et al. Intentional coverage of the left subclavian artery during endovascular repair of traumatic descending thoracic aortic transection. J Vasc Surg. 2013;57(3):684–90 (e1).CrossRef
Metadata
Title
Mid-term outcomes of endovascular repair for traumatic thoracic aortic injury: a single-center experience
Authors
Shin-Ah Son
Hanna Jung
Joon Yong Cho
Tak-Hyuk Oh
Young Woo Do
Kyoung Hoon Lim
Gun-Jik Kim
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 6/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-019-01166-6

Other articles of this Issue 6/2019

European Journal of Trauma and Emergency Surgery 6/2019 Go to the issue

Review Article

Selective non-operative management for penetrating splenic trauma: a systematic review

Original Article

Contrast-induced nephropathy following CT scan for trauma is not rare and is associated with increased mortality in South African trauma patients

Original Article

Comparative analysis of non-simultaneous bilateral fractures of the proximal femur

Original Paper

Anteromedial femoral neck plate with cannulated screws for the treatment of irreducible displaced femoral neck fracture in young patients: a preliminary study

Original Article

Pre-hospital rescue times and interventions in severe trauma in Germany and the Netherlands: a matched-pairs analysis

Original Article

Health-related quality of life in trauma patients at 12 months after injury: a prospective cohort study