Endovascular repair of thoracic and abdominal aortic ruptures: a single-center experience

İslim, Filiz; Salık, Aysun Erbahçeci; Güven, Koray; Bakuy, Vedat; Çukurova, Zafer

doi:10.5152/dir.2013.13165

Cited by 6 publications

(5 citation statements)

References 35 publications

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“…12,13 However, the hemodynamic stability of the patient, any associated comorbidities and concomitant injuries, and the suitability of the vascular anatomy for endovascular repair should all be assessed as part of patient selection. 14 Open surgery is still the best option for patients with unstable vital signs, and an endovascular approach can be applied to stable patients. 11 Shalhub et al 15 reported that the abdominal aorta zones of injury were classified by possible surgical approaches as zone I (diaphragmatic hiatus to superior mesenteric artery [SMA]), zone II (includes SMA and renal arteries), and zone III (from the inferior aspect of the renal arteries to the aortic bifurcation).…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Abdominal Aortic Rupture During Transpedicular Bone Grafting for Thoracolumbar Burst Fractures Successfully Treated by Endovascular Stent Implantation

et al. 2023

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Purpose: Vascular injury resulting from transpedicular bone grafting in the treatment of thoracolumbar burst fractures has not been reported but can be lethal. The management of patients with iatrogenic aortic injury remains a difficult clinical problem. This study describes a case of iatrogenic abdominal aortic rupture at the level of L2 during transpedicular bone grafting for the first time. Case Report: A 55 year-old male patient suffered from a T12 vertebral body mild compression fracture and an L2 vertebral body burst fracture due to falling. This patient was treated with posterior open reduction and pedicle screw fixation combined with transpedicular bone grafting in the L2 vertebrae using a paravertebral approach. Unfortunately, during transpedicular bone grafting, the abdominal aorta was punctured by the tip of the graft funnel. The use of endovascular stent implantation successfully averted a clinical catastrophe. The patient had a good clinical outcome, and no complications associated with vascular trauma were apparent at a 1-year follow-up examination. Conclusion: For the repair of vascular injury caused by transpedicular bone grafting, endovascular techniques can provide a safe, minimally invasive, and effective treatment option. Clinical Impact Surgeons should carefully evaluate the specificity of the patient’s anatomical structures preoperatively and be more cautious during transpedicular bone grafting in the treatment of thoracolumbar burst fractures.

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Section: Discussionmentioning

confidence: 99%

Iatrogenic Abdominal Aortic Rupture During Transpedicular Bone Grafting for Thoracolumbar Burst Fractures Successfully Treated by Endovascular Stent Implantation

et al. 2023

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“…Interestingly, there was no in-hospital or 30-days mortality observed in our patients. Thirty days mortality rate has been described to be as high as 27% in patients presenting with thoracic or abdominal aortic rupture (7), and as low as 4% in those patients with chronic thoracic and abdominal disease (12), while higher mortality rate in EVAR patients is associated with infection (13). Thirty das mortality rates has been reached 9% after EVAR and only 1.7% in those without intervention, but with a rupture aneurysma rate of 9 per 100 persons years (14).…”

Section: Discussionmentioning

confidence: 99%

Endovascular repair in patients with aortic dissection and aortic aneurysm: A retrospective cohort study.

Alvarez-Covarrubias,

Uribe-González,

Montoya-Guerrero

et al. 2023

Preprint

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Background Therapeutic options in patients with aortic diseases include medical treatment, surgical and percutaneous intervention. The latter has been proved to be safe in patients with aortic aneurysm (AA) and aortic dissection (AD), but still represents challenging and with significant mortality rates. For these reasons, we aimed to compare procedural and in-hospital complications in patients with AA and AD treated with transfemoral transcatheter endovascular aortic repair (EVAR). Methods Patients treated using transfemoral EVAR from 2012 to 2017 at the Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City with complete computed tomography (CT) and diagnostic of AA and AD were included. Procedural and in-hospital related complications were compared among patients treated due to AA and AD. Endpoints of the study were in-hospital and thirty days all-cause mortality and any cause of readmission. Results A total of 38 patients with high quality CT were included in the analysis. From them, 25 had AA and 13 AD. Mean age was 64 ± 14 yeas, 23.7% were females. Urgent treatment was required in 31.6%, the number of prosthesis used was 2.13 [1, 5] per patients. No in-hospital mortality was observed. Type 1a endoleak was similar in both groups (AA 8% vs. AD 15.4%, p = 0.59). Conversion to surgery was needed only in one patient (AA 4% vs AD 0%, p > 0.99). No difference was observed regarding endovascular reintervention (16% vs. 15.4%, p > 0.99), graft thrombosis (12% vs. 0%, p = 0.53), spinal cord injury (0% vs. 15.4%, p = 0.11) or vascular complication (8% vs. 15.4%, p = 0.59%) between AA and AD respectively. No 30-days mortality was observed. Conclusions EVAR represents a safe procedure in patients presenting with AA or AD, with no in-hospital or 30 days mortality rate and very low reintervention rate.

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“…Thirty-two articles were excluded, leaving 16 retrospective cohort studies comprising 238 participants in the final analysis. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] The search strategy is shown in Figure 1 and is based upon the PRISMA flow diagram systematic reviews. 12 Table 1 summarises the characteristics of included studies.…”

Section: Systematic Search Strategymentioning

confidence: 99%

The endovascular repair of blunt traumatic thoracic aortic injury in Asia: A systematic review and meta-analysis

Wee

Syn

et al. 2019

Vascular

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Introduction Blunt traumatic thoracic aortic injury, the second leading cause of death from trauma, poses unique challenges in its management. However, there has not yet been a corresponding consolidated series of outcomes reported in Asia, which this systematic review aims to address. Method This review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Searches were performed on MEDLINE, EMBASE, Google Scholar, and Cochrane Database for studies performed in Asia reporting the endovascular management of blunt traumatic thoracic aortic injury. Risk of bias was assessed using the Newcastle-Ottawa scale. Meta-analyses of pooled proportions were performed using the metaprop command in STATA. This review has been prospectively registered in PROSPERO (CRD42018083773). Results Sixteen retrospective cohort studies were included, reporting a total of 238 patients. The pooled Injury Severity Score was 32.5 (95%CI 27.8–37.1). The pooled mean time to operation from diagnosis was 39.2 hours (95%CI 24.6–53.8 hours), and operation time was 100 min (95%CI 63.5–136.5 min). The pooled rate of procedural conversion from endovascular repair to open surgery was 0.17% (95%CI 0–3.7%), and the proportion of left subclavian artery coverage was 55% (95%CI 37–72%). The pooled prevalence of intra-operative all-cause and aortic-related mortality was 0.72% (95%CI 0–4.9%) and 0.27% (95%CI 0–3.8%), respectively. The pooled prevalence of 30-day all-cause and aortic-related mortality was 2.2% (95%CI 0.16–5.6%) and 2.1% (95%CI 0–3.7%), respectively. In terms of 30-day complication, the pooled prevalence rates of type 1 endoleak, endograft complications, vascular access injury, strokes, and aortic re-rupture were 1.2%, 0.34%, 0.14%, 0.02%, and 0.01%, respectively. There were no cases of types II and III endoleak, and renal failure. Conclusion Short- to mid-term results for thoracic endovascular aortic repair for blunt traumatic thoracic aortic injury in Asia are encouraging. However, there is a distinct disparity in reporting across Asia. We propose a prospective database for outcome reporting post thoracic endovascular aortic repair in this patient population, and ongoing follow up to assess long-term efficacy of this treatment strategy.

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Endovascular repair of thoracic and abdominal aortic ruptures: a single-center experience

Cited by 6 publications

References 35 publications

Iatrogenic Abdominal Aortic Rupture During Transpedicular Bone Grafting for Thoracolumbar Burst Fractures Successfully Treated by Endovascular Stent Implantation

Iatrogenic Abdominal Aortic Rupture During Transpedicular Bone Grafting for Thoracolumbar Burst Fractures Successfully Treated by Endovascular Stent Implantation

Endovascular repair in patients with aortic dissection and aortic aneurysm: A retrospective cohort study.

The endovascular repair of blunt traumatic thoracic aortic injury in Asia: A systematic review and meta-analysis

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