Traumatic Aortic Rupture: 30 Years of Experience

Malliet, Cindy; Houthoofd, Sabrina; Daenens, Kim; Geert, Maleux; Fourneau, Inge

doi:10.1016/j.avsg.2010.12.019

Cited by 19 publications

(10 citation statements)

References 24 publications

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“…TEVAR is now the therapy of choice for most patients with aneurysms and dissections in the descending aorta. 6,7 The main advantages compared to open surgery are less surgical trauma, less bleeding, and a lower risk of spinal cord ischemia. 6,7 However, stroke rates remain similar, at approximately 2%-5%.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 The main advantages compared to open surgery are less surgical trauma, less bleeding, and a lower risk of spinal cord ischemia. 6,7 However, stroke rates remain similar, at approximately 2%-5%. 8 Furthermore, the aortic arch is the predicted next frontier for aortic endografting, 9,10 but enthusiasm is tempered by the higher stroke rate the more proximal the endograft is placed in the arch.…”

Section: Discussionmentioning

confidence: 99%

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Air bubbles are released by thoracic endograft deployment: An in vitro experimental study

et al. 2016

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Purpose:Embolic stroke is a dreaded complication of thoracic endovascular aortic repair. The prevailing theory about its cause is that particulate debris from atherosclerotic lesions in the aortic wall are dislodged by endovascular instruments and embolize to the brain. An alternative source of embolism might be air trapped in the endograft delivery system. The aim of this experimental study was to determine whether air is released during deployment of a thoracic endograft.Methods:In an experimental benchtop study, eight thoracic endografts (five Medtronic Valiant Thoracic and three Gore TAG) were deployed in a water-filled transparent container drained from air. Endografts were prepared and deployed according to their instructions for use. Deployment was filmed and the volume of air released was collected and measured in a calibrated syringe.Results:Air was released from all the endografts examined. Air volumes ranged from 0.1 to 0.3 mL for Medtronic Valiant Thoracic and from <0.025 to 0.04 mL for Gore TAG. The largest bubbles had a diameter of approximately 3 mm and came from the proximal end of the Medtronic Valiant device.Conclusion:Air bubbles are released from thoracic endografts during deployment. Air embolism may be an alternative cause of stroke during thoracic endovascular aortic repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Air bubbles are released by thoracic endograft deployment: An in vitro experimental study

et al. 2016

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“…Other causes include direct blows or falls from significant height [ 1 , 5 ]. Of those patients that reach hospital, there is over 85% mortality within ten weeks if no treatment is initiated [ 6 ]. In 1-2% however, where traumatic aortic injury initially goes unrecognised, a chronic traumatic aortic aneurysm may form [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Conventional surgical repair involves a high posterolateral thoracotomy with or without cardiopulmonary bypass [ 7 ]. Complications include spinal cord injury, bleeding, and stroke [ 1 , 6 , 7 ]. The less invasive approach of TEVAR involves the implantation of a stent graft across the aneurysm under imaging guidance [ 5 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic Thoracic Aortic Aneurysm Presenting 29 Years following Trauma

Miller

Kumar

Bosch

et al. 2015

Case Reports in Surgery

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Blunt, nonpenetrating injuries of the thoracic aorta are uncommon and associated with a high mortality rate within the first hour. Aortic injury is missed in 1-2% of patients that survive to hospital, and a chronic thoracic aortic aneurysm may subsequently form. We present a case in which a chronic thoracic aortic aneurysm was diagnosed 29 years following a significant motor vehicle accident. We discuss the epidemiology, presentation, and management of this uncommon consequence of blunt, nonpenetrating aortic injury. Our case illustrates an important clinical lesson; a past medical history of trauma should not be overlooked at any patient assessment.

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“…Die erste endovaskuläre Stent-graft Versorgung der Aorta descendens wurde 1987 durchgeführt [65]. Seither wurde die Stentversorgung zunächst lediglich als Überbrückungsmaßnahme bis zur definitiven chirurgischen Versorgung betrachtet; tatsächlich aber kam es zwischenzeitlich zu einem Paradigmenwechsel, und die Intervention mit thoracic endovascular aortic repair (TEVAR) ist zur bevorzugten Behandlungsform der traumatischen Aortenruptur geworden [66,67]. Im Vergleich mit der offenen Operation haben mehrere Metaanalysen Vorteile für die endovaskuläre Versorgung gezeigt; etwa eine deutlich niedrigere prozedurale und 30-Tage Letalitätsrate mit 9-19 % vs. 19-36 %, Paraplegie 3 % vs. 5,5.-9 %, Nierenversagen 3 % vs. 8 %, Graft-Infektion 3 % vs. 11 %, systemische Infektion 5 % vs. 13 % [43,44,68,69].…”

Section: Tevarunclassified

Die traumatische Aortenruptur

Schachner

Oji-Zurmeyer

Rylski

et al. 2019

Wien Med Wochenschr

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Zusammenfassung Verkehrsunfälle sind für den größten Teil der traumatischen Aortenrupturen verantwortlich, meist zusammen mit weiteren schweren Begleitverletzungen. Die prähospitale Sterblichkeit ist hoch. Bei Verdacht auf eine beteiligte Aortenverletzung, aufgrund eines hohen traumatic aortic injury scores, ist eine Computertomographie durchzuführen. Es erfolgt eine Triage der Verletzungen, und die Versorgungspriorität der Aorta richtet sich nach dem Schweregrad der Aorten-und Begleitverletzungen sowie dem Zustand des Patienten. Bis zur definitiven Versorgung der aortalen Läsion muss der Blutdruck konsequent gesenkt werden. Grad I und II können in Einzelfällen unter enger Kontrolle inital konservativ gemanagt werden. Grad III (gedeckte Ruptur) und Grad IV (freie Ruptur) benötigen eine raschestmögliche Versorgung (interventionell, chirurgisch).

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Traumatic Aortic Rupture: 30 Years of Experience

Cited by 19 publications

References 24 publications

Air bubbles are released by thoracic endograft deployment: An in vitro experimental study

Air bubbles are released by thoracic endograft deployment: An in vitro experimental study

Chronic Thoracic Aortic Aneurysm Presenting 29 Years following Trauma

Die traumatische Aortenruptur

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