Open versus endovascular repair of traumatic aortic rupture: A systematic review

Akowuah, Enoch; Angelini, Gianni; Bryan, Alan J.

doi:10.1016/j.jtcvs.2008.05.047

Cited by 19 publications

(5 citation statements)

References 13 publications

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“…Endovascular aortic repair also requires considerably less time and can be done expeditiously in relatively unstable patients. A systematic review by Akowuah and colleagues 22 showed that operative mortality and postoperative paraplegia rates were significantly less for thoracic endografting compared with open surgical repair (7% vs 19% [P < .01] and 1% vs 6% [P < .01], respectively). Nevertheless, the authors stressed that long-term outcomes are poorly documented.…”

Section: Discussionmentioning

confidence: 99%

Role of conservative management in traumatic aortic injury: Comparison of long-term results of conservative, surgical, and endovascular treatment

Mosquera

Marini

López-Pérez

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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The advent of thoracic aortic endografting has enabled a revolution in the management of acute traumatic aortic injury in patients with multisystem trauma with a low in-hospital morbimortality. Nonoperative management may be only a therapeutic option with acceptable survival in carefully selected patients. The natural history of these patients has revealed a marked trend of late aortic-related complications developing, which may justify an endovascular repair even in some low-risk patients.

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Section: Discussionmentioning

confidence: 99%

Role of conservative management in traumatic aortic injury: Comparison of long-term results of conservative, surgical, and endovascular treatment

Mosquera

Marini

López-Pérez

et al. 2011

The Journal of Thoracic and Cardiovascular Surgery

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“…In a systematic review of treatments of BAIs by Akowuah, 10 articles including 262 patients were identified (153 patients undergoing surgical repair and 109 endovascular repair). Postoperative results showed a higher paraplegia rate and a greater mortality rate in the surgical repair group (1% vs. 6% and 7% vs. 19%, respectively) ( 18 ). However, the mortality associated with open repair varies from one study to another and has been reported to be as low as 5% with no case of paraplegia in a previous local report ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Traumatic Aortic Injury in a Primary Open Surgical Approach Paradigm

et al. 2015

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Background:Multiple classifications can be used to define the magnitude of aortic injury. The Vancouver Classification (VC) is a new and simplified computed tomography-based Blunt Aortic Injury (BAI) grading system correlating with clinical outcomes.Objectives:The objectives of this study are: 1) to describe the severity of aortic injury in a center with a predominantly surgical approach to BAI; 2) to correlate the severity of aortic trauma to hospital survival rate and rate of adverse events according to the type of interventions performed during the hospital stay; and 3) to evaluate VC.Patients and Methods:All patients referring to the Sacre-Coeur Hospital of Montreal between August 1998 and April 2011 for management of BAI were studied. Two radiologists reviewed all CT scan images individually and classified the aortic injuries using VC.Results:Among the 112 patients presenting with BAI, 39 cases had local CT scans available for reconstruction. Seven patients were identified as suffering from grade I injuries (flap or thrombus of less than 1 cm), 6 from grade II injuries (flap or thrombus of more than 1 cm), and 26 from grade III injuries (pseudoaneurysm). Among the patients with grade I injuries, 57% were treated surgically and 43% medically with a survival rate of 100%. Among the patients with grade II injuries (67% treated surgically and 33% treated medically) survival was also 100%. Among patients with grade III injuries (85% treated surgically, 7% had Thoracic Endovascular Aortic Repair (TEVAR) and 8% treated medically) survival was 95%, 95% and 50%, respectively. There were no significant differences between groups as to clinical outcome. Inter-rater reliability was 0.81.Conclusions:VC is easy to use and has low inter-observer variability. Low grades of injury were associated with low mortality related to medical treatment.

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“…TEVAR for ATAI was used initially in high‐risk multiple injuries or elderly patients, but in many centers it has now become the initial procedure of choice, even in young or low‐risk patients. TEVAR appears to lower mortality and morbidity rates in patients with ATAI [8, 27, 28]. Moreover, TEVAR has extended operative treatment to those patients not previously considered candidates for repair [29].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Aortic Injuries Associated with Major Visceral Vascular Injuries in Major Blunt Trauma Patients

et al. 2012

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Aortic injuries associated with MAAVB injuries in major trauma patients seem to present in a different clinical scenario. These patients present increased risk of rhabdomyolysis, visceral ischemia, and acute renal failure, as well as higher in-hospital mortality. A multidisciplinary approach combining endovascular and open surgical techniques for a staged treatment of these life-threatening aortic and MAAVB injuries is mandatory in this critical subset of trauma patients.

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Open versus endovascular repair of traumatic aortic rupture: A systematic review

Abstract: ES appears widely applicable as an emergency treatment and simplifies the treatment of other injuries. ES should be viewed as the treatment of choice for TAR.

Cited by 19 publications

References 13 publications

Role of conservative management in traumatic aortic injury: Comparison of long-term results of conservative, surgical, and endovascular treatment

Role of conservative management in traumatic aortic injury: Comparison of long-term results of conservative, surgical, and endovascular treatment

Outcomes of Traumatic Aortic Injury in a Primary Open Surgical Approach Paradigm

Traumatic Aortic Injuries Associated with Major Visceral Vascular Injuries in Major Blunt Trauma Patients

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