Thoracic Aortic Dilation after Endovascular Repair of Blunt Traumatic Aortic Injury

Tran, Kenneth; Li, Ming; Stern, Jordan R.; Lee, Jason T.

doi:10.1016/j.avsg.2020.06.049

Cited by 7 publications

(7 citation statements)

References 17 publications

(18 reference statements)

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“…Their study included 101 patients, revealing a median total growth of 4 mm in proximal and distal landing zones [32]. However, the degree of oversizing reported by these studies was smaller (or practically no oversizing in dissected aorta), than the degree of oversizing in the treatment of BTAI [6][7][8]13,15,17,19].…”

Section: Discussionmentioning

confidence: 97%

“…It appears that the proximal and distal aortic non-stented area also experienced accelerated dilation with the years. However, due to studies measurement and methodology variation, we weren't being able to quantify these processes [8,17,13,15,19]. Moreover, comparing patients who underwent TEVAR for BTAI to healthy patients also showed statistically significant dilation of the non-stented aorta [30].…”

Section: Discussionmentioning

confidence: 99%

“…Even though these studies reported an intended oversized greater than 10%. This discrepancy might be correlated to the aortic elastic force acting against endograft radial force, as well as possibly underestimated aortic diameter in hypotensive patients [8,9,13]. Moreover, the non-stented proximal ad distal aortic segment seemed to dilate but to a lesser degree [8,13,14,16,18].…”

Section: Discussionmentioning

confidence: 99%

“…For convenience purposes, if multiple segments of non-stented aortic measurements were reported by the studies, only the measurement of the non-stented-segment most closed to the aortic neck was reported. Due to variability in aortic diameter measurements, studies methodology, and data reporting, only three studies were included in the final meta-analysis comparing pre and post-intervention aortic necks' diameters change (figure 2A and 2B) [8,9,13]. Our meta-analysis (including 133 patients) suggests that post-TEVAR for BTAI patients, the aortic diameter at the level of proximal and distal aortic necks increased by 2.41 mm and 2.63 mm, respectively.…”

Section: Records Identified From*mentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Aortic Morphological Changes after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Righini,

Avishay,

Mazzaccaro

et al. 2023

Preprint

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Background: Thoracic endovascular aortic repair (TEVAR) has become the standard treatment for blunt thoracic aortic injury (BTAI). Some small observational studies revealed aortic morphological changes after TEVAR in patients with BTAI. However, these studies were limited by the rarity of the condition and small sample sizes. To address this gap, the current study aims to conduct a systematic review and meta-analysis of existing literature to provide evidence on the degree of immediate and long-term aortic diameter change following TEVAR for BTAI. Methods: This systematic review and meta-analysis of studies published up to March 2023, was conducted in accordance with the PRISMA statement. Studies eligible for inclusion were studies evaluating aortic diameter change post-TEVAR in BTAI patients. Results: 14 articles, including 353 patients, were included after review. Treatment and measurement protocols varied among individual studies resulting in high heterogeneity of the results. Our meta-analysis demonstrated an immediate post-intervention dilation 2.41 mm and 2.63 mm of the proximal and distal aortic necks’, respectively, as well as continuous dilation of the respective regions at a rate of 0.35 mm/year and 0.49 mm/year. Conclusion: TEVAR in BTAI leads to immediate post-intervention and continuous aortic dilation and morphological changes with possible future important clinical consequences.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Records Identified From*mentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Aortic Morphological Changes after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Righini,

Avishay,

Mazzaccaro

et al. 2023

Preprint

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“…This was thought to be due to the straight endograft where the distal end seems to be oversized. However, in the late-term follow-up, there are no known associated complications [31]. Depending on graft size availability, oversizing for BTTAI varies between 5-20% however for successful wall apposition and sealing without excessive radial force.…”

Section: Discussionmentioning

confidence: 99%

Endovascular therapy in blunt traumatic aortic injuries

Aşkın¹,

Mola²,

AYTEKİN³

et al. 2022

Turk J Vasc Surg

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Aim: Blunt traumatic thoracic aortic injury (BTTAI) is a catastrophic life-threatening surgical emergency and the second most common cause of death in trauma patients. We retrospectively revealed our results for endovascularly treated BTTAI with early and long-term results. Material and Methods: During January 2009 and January 2022, patients from the emergency department with diagnosed BTTAI were retrospectively revealed. 38 patients all male except two, experienced BTTAI. 5 patients had grade IV, and 21 patients had grade III aortic injuries. Results: Mean age of the patients was 41.7±12.5 years. Technical success was 100%. Early mortality was 7.9%. The mean follow-up period was 49.7±18.3 months. In the follow-up period, there were no TEVAR-related complications. Conclusion: TEVAR is the most suitable treatment for BTTAI in the modern era. Left subclavian artery (LSA) intentional coverage may be performed however surgeon modified fenestrated stent graft (SMFSG) is an effective, economic, fast, and readily available technique for LSA revascularization without additional time.

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