Long-Term Outcomes of Thoracic Endovascular Aortic Repair Focused on Bird Beak and Oversizing in Blunt Traumatic Thoracic Aortic Injury

Reyes, M.E. García; Martins, Gabriela Gonçalves; Valenzuela, V. Fernández; González, José Manuel; Lebrun, J; Bellmunt-Montoya, Sergi

doi:10.1016/j.avsg.2018.02.001

Cited by 31 publications

(22 citation statements)

References 20 publications

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“…3,6 Although the majority of studies indicate the endovascular method's superiority over open surgery in terms of rates of mortality and complications for patients with blunt aortic traumas, the medium and long term results and the durability of devices are not yet known. 13,15 The prospective RESCUE 13 study is currently evaluating the results of endovascular treatment of these patients over a 5-year follow-up period. At each visit, patients undergo clinical examination and an imaging exam (angiotomography or magnetic resonance).…”

Section: Discussionmentioning

confidence: 99%

“…García Reyes et al 15 conducted a study to investigate the long-term results of blunt thoracic aorta trauma patients treated using endovascular techniques. Mean follow-up of the participants was 98 months and the most common complication observed was intragraft thrombus (20%).…”

Section: Discussionmentioning

confidence: 99%

“…As a result, excessive oversizing is very often inevitable in patients with blunt trauma aortic injuries, because of a lack of endografts of the correct size. 15 Current recommendations in the literature limit maximum oversizing to 20%. 16 The size of the endografts used and their positioning are determinant factors in the post-treatment results.…”

Section: Discussionmentioning

confidence: 99%

“…16 The size of the endografts used and their positioning are determinant factors in the post-treatment results. García Reyes et al 15 observed that patients who exhibited complications related to endografts had greater oversizing than a subset free from complications (p = 0.0007). 15 The majority of devices currently available are not specifically designed for traumatic injuries to the aorta, and it is difficult to find the smaller sizes that would be ideal for younger patients.…”

Section: Discussionmentioning

confidence: 99%

“…García Reyes et al 15 observed that patients who exhibited complications related to endografts had greater oversizing than a subset free from complications (p = 0.0007). 15 The majority of devices currently available are not specifically designed for traumatic injuries to the aorta, and it is difficult to find the smaller sizes that would be ideal for younger patients. 16 This obliges many surgeons to implant endografts with greater oversizing, as the only viable option for endovascular treatment.…”

Section: Discussionmentioning

confidence: 99%

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Tratamento endovascular de dissecção traumática de aorta torácica – série de 16 casos

Sarquis¹,

Michaelis

Santos

et al. 2020

J. vasc. bras.

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Resumo Contexto As lesões de aorta nos traumatismos torácicos fechados possuem alta mortalidade pré-hospitalar e no serviço de emergência. O tratamento endovascular é um método de escolha para o tratamento dessas lesões; entretanto, muitos resultados em relação a essa abordagem permanecem desconhecidos. Objetivos O objetivo deste trabalho é descrever a experiência no tratamento endovascular de lesões traumáticas de aorta torácica em um centro de referência em trauma. Métodos Este trabalho trata-se de estudo descritivo realizado através da revisão de prontuários eletrônicos de pacientes vítimas de trauma contuso de aorta torácica, atendidos em um hospital de referência em trauma na cidade de Curitiba (Paraná, Brasil). Resultados Dezesseis pacientes foram incluídos no estudo. Todos os pacientes foram vítimas de acidente de trânsito, sendo que 75% dos acidentes ocorreram por colisão entre veículos. As lesões de aorta variaram de Grau I a IV, e a maioria dos pacientes apresentou lesão de grau II (50%). Todos os pacientes foram submetidos a terapia endovascular com implante de endoprótese sendo realizado em média 71 horas após o trauma. Dois pacientes evoluíram a óbito, porém de causas não relacionadas à lesão de aorta. Durante o seguimento, apenas dois pacientes apresentaram complicações (endoleak e progressão da dissecção). Conclusões O método endovascular é uma alternativa viável no tratamento de lesões de aorta torácica por trauma contuso. São necessários estudos randomizados e controlados a fim de reforçar a indicação desse método como terapia para esse tipo de lesão.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Tratamento endovascular de dissecção traumática de aorta torácica – série de 16 casos

Sarquis¹,

Michaelis

Santos

et al. 2020

J. vasc. bras.

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

Son

Jung

Cho

et al. 2019

Eur J Trauma Emerg Surg

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Endovascular Stent-Graft Repair of the Ascending Aorta: Assessment of a Specific Novel Stent-Graft Design in Phantom, Cadaveric, and Clinical Application

Hauck

Kupferthaler

Stelzmüller

et al. 2021

Cardiovasc Intervent Radiol

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Purpose To test a stent-graft specifically designed for the ascending aorta in phantom, cadaver, and clinical application, and to measure deployment accuracy to overcome limitations of existing devices. Methods A stent-graft has been designed with support wires to fixate the apices toward the inner curvature, thereby eliminating the forward movement of the proximal end which can happen with circumferential tip capture systems. The device was deployed in three aortic phantoms, and in four cadavers, deployment precision was measured. Subsequently, the device was implanted in a patient to exclude a pseudoaneurysm originating from the distal anastomosis after ascending aortic replacement. Results The stent-grafts were successfully deployed in all phantoms and cadavers. Deployment accuracy of the proximal end of the stent-graft was within 1 mm proximally and 14 mm distally to the intended landing zone on the inner curvature, and 2–8 mm distal to the intended landing zone on the outer curvature. In clinical application, the pseudoaneurysm could be successfully excluded without complications. Conclusion The novel stent-graft design promises accurate placement in the ascending aorta. The differential deployment of the apices at the inner and outer curvatures allows deployment perpendicular to the aortic axis. Level of Evidence No level of evidence.

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Long-Term Outcomes of Thoracic Endovascular Aortic Repair Focused on Bird Beak and Oversizing in Blunt Traumatic Thoracic Aortic Injury

Cited by 31 publications

References 20 publications

Tratamento endovascular de dissecção traumática de aorta torácica – série de 16 casos

Tratamento endovascular de dissecção traumática de aorta torácica – série de 16 casos

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

Endovascular Stent-Graft Repair of the Ascending Aorta: Assessment of a Specific Novel Stent-Graft Design in Phantom, Cadaveric, and Clinical Application

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