Emergent Repair of Acute Thoracic Aortic Catastrophes

Naughton, Peter

doi:10.1001/archsurg.2011.1476

Cited by 39 publications

(37 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The risk of paraplegia is known to be low in cases of surgical aortic fenestration because, as opposed to aortic graft replacement and stentgraft implantation, the intercostal arteries are not permanently excluded from the circulation. The reported 30 day mortality rate (21.4%) is similar to the early mortality rates that can be found in other open surgical studies (16.7e29%), 9,14,15 but slightly worse than the mortality rates of aortic stentgraft implantation (0e 17%). 14e16, 19 In this study the 5 year survival rate was 70.6%, which is similar to the surgical and endosurgical survival rates published in the literature (60.9e82.6% and 61e84%, respectively).…”

Section: Discussionsupporting

confidence: 86%

Early and Long-term Outcome after Open Surgical Suprarenal Aortic Fenestration in Patients with Complicated Acute Type B Aortic Dissection

Szeberin

Dósa

Fehérvári

et al. 2015

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 86%

Early and Long-term Outcome after Open Surgical Suprarenal Aortic Fenestration in Patients with Complicated Acute Type B Aortic Dissection

Szeberin

Dósa

Fehérvári

et al. 2015

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

show abstract

“…1,5,6,22e25 The 12.5% in hospital mortality rate is good if compared with the 35.3% predicted pre-operatively, and it is consistent with the average 19.4% emerging from previous published series which have included all aortic pathologies as underlying causes of the thoracic aortic rupture. 1,5,6,8,22,23 By contrast, the long-term benefit of TEVAR has been associated with conflicting results. Goodney et al 21 found that patients selected for TEVAR had worse long-term survival than patients selected for open repair.…”

Section: Population Based Analysis and Single Center Studies Have Repmentioning

confidence: 99%

“…The incidence of respiratory complications after TEVAR for thoracic aortic rupture has been reported in the range of 15e 39%. 2,4,5,22,25 A recent nationwide study on use and outcomes of TEVAR for ruptured thoracic aortic aneurysms reported that respiratory complications were alarmingly high at 63%, and even higher in the TEVAR group compared with conventional repair. 3 However, when pleural effusion or HTX were eliminated from the final analysis the respiratory complications were lower in the TEVAR group.…”

Section: Population Based Analysis and Single Center Studies Have Repmentioning

confidence: 99%

Hemothorax Management After Endovascular Treatment For Thoracic Aortic Rupture

Piffaretti

Menegolo

Kahlberg

et al. 2015

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

Thoracic aortic rupture still has a high mortality rate. Respiratory complications have not been eliminated by endovascular repair. HTX evacuation may have had a positive influence on the survival in these patients. Although traumatic and degenerative ruptures are two significantly different scenarios, survival and respiratory outcomes were similar and were not affected by the underlying aortic disease.

show abstract

“…[12,13] The major uses of endovascular techniques for trauma are bleeding control interventions such as balloon occlusion, embolization, and deployment of a covered stent, exclusion of pseudoaneurysms and arteriovenous fistulas by either covered stents or coil embolization, and deployment of bare metal stents or covered stents for dissection. [11,[14][15][16] In our daily practice, we have been using endovascular interventions increasingly for our elective cases; however, due to the lack of endovascular capabilities in the operating room, the number of emergency cases treated with this modality still remains low. In the present study, only one patient was treated with an endograft for ruptured subclavian artery, and one other patient underwent thoracic endovascular graft implantation, [17] although our number has been increasing since that time.…”

Section: Discussionmentioning

confidence: 99%

Emergency vascular injuries: patient profile, management strategies and risk factors for mortality

Kayalar¹

2017

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

ÖZAmaç: Bu çalışmada yaralanmanın mekanizmaları ve yerleri, tanı, hasta profili, tedavi yöntemleri ve mortalite risk faktörleri değerlendirildi ve acil vasküler yaralanmaların tedavisine yönelik damar cerrahları için bir rehber sunuldu. Ça lış ma pla nı: Eylül 2009 -Haziran 2013 tarihleri arasında toplam 161 hasta (156 erkek, 5 kadın; ort. yaş: 30.3±11.8 yıl; dağılım 8-80 yıl) vasküler yaralanma nedeniyle cerrahi olarak kliniğimizde tedavi edildi. Hastaların tümü klinik değerlendirme sonrası acil olarak veya Doppler ultrason, bilgisayarlı tomografi anjiyografi veya manyetik rezonans anjiyografi gibi tanısal görüntüleme sonrası ameliyata alındı. Bul gu lar: Delici yaralanmalar (%89.4) daha sık olup, yaralanmaların büyük bir çoğunluğu üst ekstremite (%49.1) takiben alt ekstremiteyi (%41), batını (%5.6), boynu (%2.5) ve toraksı (%1.9) içermekteydi. Küçük damar yaralanmalarında basit bağlama tekniği kullanılırken (%14.3), daha karmaşık durumlarda uç uca anastomoz (%49.7) ve safen ven (%32.3) veya protez greft (%4.3) ile onarım yapıldı. On hastada (%6.2) mortalite gözlendi. Mortalite için majör risk faktörleri; yaralanmanın batını içermesi (p<0.001), başvuru sırasında hemodinamik instabilite (p<0.001) ve ameliyat öncesi düşük hematokrit değerleri (18.1±9.1'e kıyasla 33.4±5.6; p<0.001) idi. So nuç: Vasküler yaralanmalarda hızla tanı konulmalı ve tedavi başlanmalıdır. Başvuru sırasındaki klinik durum, yaralanmanın yeri, tanı ve tedavi seçeneklerinin farklılığı ve eşlik eden yaralanmalar dikkate alınması gereken önemli sorunlardır. Pek çok acil durumda yalnızca klinik değerlendirme yeterli olabilir. Hemodinamik instabilite ve ciddi kan kaybı olan hastalarda, hasta kaybını önlemek için, eş zamanlı cerrahi tedavi ve tıbbi resüsitasyon birlikte uygulanmalıdır.Anah tarsöz cük ler: Mortalite; risk faktörleri; cerrahi tedavi; vasküler travma. ABSTRACTBackground: This study aims to evaluate the mechanisms and localizations of injury, diagnosis, patient profile, treatment modalities, and risk factors for mortality, and to offer a guide for vascular surgeons for the management of emergency vascular injuries. Methods: Between September 2009 and June 2013, a total of 161 patients (156 males, 5 females; mean age 30.3±11.8 years; range 8 to 80 years) were surgically treated for vascular injuries in our clinic. All patients were taken to the operation emergently after clinical assessment or after diagnostic imaging using Doppler ultrasound, computed tomography angiography or magnetic resonance angiography. Results:Penetrating injuries (89.4%) were more common and most injuries involved the upper extremity (49.1%), followed by the lower extremity (41%), abdomen (5.6%), neck (2.5%), and thorax (1.9%). Simple ligation technique (14.3%) was used for small vessel injuries, whereas end-to-end anastomosis (49.7%) and repair with a saphenous vein (32.3%) or prosthetic graft (4.3%) was used for more complex cases. Mortality was seen in 10 patients (6.2%). Major risk factors for mortality were abdominal localization of injury (p<0.001), hemody...

show abstract

Emergent Repair of Acute Thoracic Aortic Catastrophes

Cited by 39 publications

References 31 publications

Early and Long-term Outcome after Open Surgical Suprarenal Aortic Fenestration in Patients with Complicated Acute Type B Aortic Dissection

Early and Long-term Outcome after Open Surgical Suprarenal Aortic Fenestration in Patients with Complicated Acute Type B Aortic Dissection

Hemothorax Management After Endovascular Treatment For Thoracic Aortic Rupture

Emergency vascular injuries: patient profile, management strategies and risk factors for mortality

Contact Info

Product

Resources

About