Outcomes of surgical and endovascular treatment of acute traumatic thoracic aortic injury.

Abstract:

BACKGROUND:Acute thoracic aortic injury resulting from blunt trauma is a life-threatening condition. Endovascular therapy is a less invasive treatment modality that may potentially improve patient outcomes. We reviewed our experience with patients who sustained blunt thoracic aortic injuries distal to the left subclavian artery and presented for open surgical or endovascular repair. METHODS:Between August 1993 and August 2006, 62 patients sustained blunt thoracic aortic injuries distal to the origin of the left subclavian artery and proceeded to undergo open surgical (n = 48, 77%), or endovascular repair (n = 14, 23%). Revised trauma score (RTS), injury severity score (ISS), new injury severity score (NISS), individual associated traumatic injuries, as well as operative and postoperative outcomes were compared between open surgical and endovascular groups. RESULTS:Age, gender, race, and mechanism of injury did not differ between open surgical and endovascular groups. Additionally, RTS, ISS, and NISS values were not significantly different. The proportion of patients with sternal fractures (14% vs 0%), or unstable spinal fractures (36% vs 10%) was significantly greater in the endovascular group. Of the patients who received endografts, 93% (n = 13) were evaluated by a cardiothoracic surgeon and assessed to be prohibitive to operative intervention. Endografts utilized included commercially manufactured thoracic endografts (n = 6; 43%) and abdominal aortic endograft components (n = 8; 57%). Forty-one interposition grafts were placed in the open surgical group. Renal complications (32% vs 7%), and urinary tract infections (35% vs 7%) approached significance between surgical and endovascular groups (P = .082 and P = .077, respectively). Intraoperative mortality for the surgical and endovascular groups was 23% and 0%, respectively (P = .056). Endovascular repair was associated with significant reductions in operative time (118 vs 209 minutes), estimated blood loss (77 vs 3180 ml), and intraoperative blood transfusions (0.9 vs 6.1 units). No endoleaks were detected during a mean follow-up of 9.4 months in the endovascular group. CONCLUSION:Endovascular repair of blunt descending thoracic aortic injuries utilizing thoracic or abdominal endographs is a technically feasible modality that is at least equivalent to open therapy in the short term and associated with a lower intraoperative mortality (P = .056). Endovascular therapy has advantages in operative time, operative blood loss, and intraoperative blood transfusions.

journal_name

J Vasc Surg

authors

Riesenman PJ,Farber MA,Rich PB,Sheridan BC,Mendes RR,Marston WA,Keagy BA

doi

10.1016/j.jvs.2007.07.029

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

934-40

issue

5

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(07)01191-3

journal_volume

46

pub_type

杂志文章
  • Diagnosis, management, and future developments of fibromuscular dysplasia.

    abstract::Fibromuscular dysplasia (FMD) is a nonatherosclerotic noninflammatory vascular disease that primarily affects women from age 20 to 60, but may also occur in infants and children, men, and the elderly. It most commonly affects the renal and carotid arteries but has been observed in almost every artery in the body. FMD ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.jvs.2010.10.066

    authors: Olin JW,Sealove BA

    更新日期:2011-03-01 00:00:00

  • Improved survival after introduction of an emergency endovascular therapy protocol for ruptured abdominal aortic aneurysms.

    abstract:BACKGROUND:The study was conducted to demonstrate improved survival (30-day mortality) after the introduction of an emergency endovascular therapy protocol for ruptured abdominal aortic aneurysms (rAAA). Numerous authors have successfully demonstrated reduced mortality in patients with rAAA using endovascular technique...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2006.11.047

    authors: Moore R,Nutley M,Cina CS,Motamedi M,Faris P,Abuznadah W

    更新日期:2007-03-01 00:00:00

  • Aortoiliac remodeling and 5-year outcome of an ultralow-profile endograft.

    abstract:BACKGROUND:Remodeling of the aortoiliac anatomy is a challenge to the long-term performance of stent grafts for endovascular aneurysm repair. Changes in vessel diameter and length can result in loss of seal at attachment sites, limb disunion, or kinking, with the development of high-pressure endoleaks, migration, or li...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jvs.2018.09.059

    authors: Torsello G,Pratesi G,van der Meulen S,Ouriel K,INNOVATION trial collaborators.

    更新日期:2019-06-01 00:00:00

  • 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors reduce the risk of perioperative stroke and mortality after carotid endarterectomy.

    abstract:OBJECTIVE:There is increasing evidence that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) reduce cardiovascular and cerebrovascular events through anti-inflammatory, plaque stabilization, and neuroprotective effects independent of lipid lowering. This study was designed to investigate whether sta...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2005.08.039

    authors: McGirt MJ,Perler BA,Brooke BS,Woodworth GF,Coon A,Jain S,Buck D,Roseborough GS,Tamargo RJ,Heller J,Freischlag JA,Williams GM

    更新日期:2005-11-01 00:00:00

  • Operative and nonoperative management of children aged 13 years or younger with arterial trauma of the extremities.

    abstract:BACKGROUND:Previous studies have suggested that open repair of arterial injuries in very young children often leads to less satisfactory outcomes. The aim of this study is to describe a decade's experience in the management of pediatric arterial trauma of the limbs, with an additional specific objective to evaluate the...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2005.09.031

    authors: Lazarides MK,Georgiadis GS,Papas TT,Gardikis S,Maltezos C

    更新日期:2006-01-01 00:00:00

  • Utility of skin perfusion pressure values with the Society for Vascular Surgery Wound, Ischemia, and foot Infection classification system.

    abstract:OBJECTIVE:The addition of skin perfusion pressure (SPP) might enhance the predictive value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system. The purpose of the present study was to evaluate the SPP for each WIfI classification stage among patients with foot wounds by ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jvs.2019.01.045

    authors: Kimura T,Watanabe Y,Tokuoka S,Nagashima F,Ebisudani S,Inagawa K

    更新日期:2019-10-01 00:00:00

  • Isolated iliac artery aneurysms: a contemporary comparison of endovascular and open repair.

    abstract:OBJECTIVE:Iliac artery aneurysms are rare but associated with significant morbidity and mortality when ruptured. This study compares recent open and endovascular repairs of iliac aneurysms at a single institution. METHODS:Patients were identified and charts reviewed using ICD-9 and CPT codes for iliac artery aneurysm ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2007.11.008

    authors: Chaer RA,Barbato JE,Lin SC,Zenati M,Kent KC,McKinsey JF

    更新日期:2008-04-01 00:00:00

  • Interaction between frailty and sex on mortality after elective abdominal aortic aneurysm repair.

    abstract:BACKGROUND:Controversy exists surrounding gender outcome disparity and abdominal aortic aneurysm (AAA) repair. Previous reports have demonstrated worse outcomes for women undergoing open aneurysm repair (OAR); however, these differences are less evident with endovascular aneurysm repair (EVAR). Epidemiologic studies ha...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2019.01.086

    authors: Barbey SM,Scali ST,Kubilis P,Beck AW,Goodney P,Giles KA,Berceli SA,Huber TS,Upchurch GR,Yaghjyan L

    更新日期:2019-12-01 00:00:00

  • Comparison of outcomes with coils versus vascular plug embolization of the internal iliac artery for endovascular aortoiliac aneurysm repair.

    abstract:OBJECTIVE:To compare the safety and efficacy of coil embolization (COIL) to Amplatzer vascular plug embolization (PLUG) to achieve internal iliac artery (IIA) occlusion prior to endovascular aortiliac aneurysm repair (EVAR). METHODS:Data from consecutive patients who underwent IIA embolization prior to EVAR over a 6-y...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2012.05.001

    authors: Ryer EJ,Garvin RP,Webb TP,Franklin DP,Elmore JR

    更新日期:2012-11-01 00:00:00

  • Transfemoral endovascular treatment of proximal common carotid artery lesions: a single-center experience on 153 lesions.

    abstract:PURPOSE:To assess primary success and safety of percutaneous transluminal angioplasty (PTA) and/or stenting of ostial/proximal common carotid artery lesions (pCCA) and to compare its 30-day stroke/mortality level with the literature data for surgical options. METHODS:A total of 147 patients (153 stenoses, 6 recurrent)...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2008.03.008

    authors: Paukovits TM,Haász J,Molnár A,Szeberin Z,Nemes B,Varga D,Hüttl K,Bérczi V,Léránt G

    更新日期:2008-07-01 00:00:00

  • The use of intravascular ultrasound in the treatment of type B aortic dissection with thoracic endovascular aneurysm repair is associated with improved long-term survival.

    abstract:OBJECTIVE:Intravascular ultrasound (IVUS) examination is an integral technique used for treating type B aortic dissection (TBAD) because it verifies true lumen access. The purpose of this study was to evaluate the use of IVUS, to determine factors associated with IVUS use, and to investigate the potential survival bene...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2019.10.073

    authors: Belkin N,Jackson BM,Foley PJ,Damrauer SM,Kalapatapu V,Golden MA,Fairman RM,Wang GJ

    更新日期:2020-08-01 00:00:00

  • Results of the ROADSTER multicenter trial of transcarotid stenting with dynamic flow reversal.

    abstract:OBJECTIVE:This report presents the 30-day results of the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial and evaluates the safety and efficacy of ENROUTE Transcarotid NPS (Silk Road Medical Inc, Sunnyvale, Calif), a novel transcarotid neuroprotection...

    journal_title:Journal of vascular surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1016/j.jvs.2015.04.460

    authors: Kwolek CJ,Jaff MR,Leal JI,Hopkins LN,Shah RM,Hanover TM,Macdonald S,Cambria RP

    更新日期:2015-11-01 00:00:00

  • Reintervention after thoracic endovascular aortic repair of complicated aortic dissection.

    abstract:OBJECTIVE:This study assessed predictive factors for reintervention after thoracic endovascular aortic repair (TEVAR) for complicated aortic dissection (C-AD). METHODS:An institutional review of consecutive TEVAR for C-AD was performed. RESULTS:Between 2000 and 2011, 41 patients underwent TEVAR for a C-AD involving t...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2013.08.089

    authors: Faure EM,Canaud L,Agostini C,Shaub R,Böge G,Marty-ané C,Alric P

    更新日期:2014-02-01 00:00:00

  • Compound polyglactin 910/polypropylene small vessel prostheses.

    abstract::This study evaluated morphologic and functional characteristics of tissue reactions to compound prostheses of 69% absorbable polyglactin 910 (PG910) and 31% nonabsorbable polypropylene in the rabbit. Forty-two woven PG910/polypropylene prostheses (24 X 4 mm internal diameter) implanted into rabbit infrarenal aortas we...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1067/mva.1987.avs0050572

    authors: Greisler HP,Kim DU,Dennis JW,Klosak JJ,Widerborg KA,Endean ED,Raymond RM,Ellinger J

    更新日期:1987-04-01 00:00:00

  • In vitro testing of a newly developed arteriovenous double-outflow graft.

    abstract:INTRODUCTION:The long-term prognosis of arteriovenous polytetrafluoroethylene (PTFE) hemodialysis grafts remains poor, causing significant morbidity and costs. The high failure rate is due to a stenosis development of the graft-vein anastomosis, consisting of two pathophysiologically separate and characteristic lesions...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2010.03.019

    authors: Heise M,Kirschner P,Rabsch A,Zanow J,Settmacher U,Heidenhain C

    更新日期:2010-08-01 00:00:00

  • Outcomes of endovascular aneurysm repair with selective internal iliac artery coverage without coil embolization.

    abstract:OBJECTIVE:Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) that also involve the common iliac artery (CIA) typically is accomplished by endograft limb extension into the external iliac artery (EIA). In order to prevent endoleak, the internal iliac artery (IIA) is usually embolized, or alternativ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2011.08.063

    authors: Papazoglou KO,Sfyroeras GS,Zambas N,Konstantinidis K,Kakkos SK,Mitka M

    更新日期:2012-08-01 00:00:00

  • The risk of ischemic spinal cord injury in patients undergoing graft replacement for thoracoabdominal aortic aneurysms.

    abstract:PURPOSE:We developed a monitoring system to detect spinal cord ischemia during aortic cross-clamping (AXC). This system was used to prospectively determine in which patients ischemia occurs, in which patients reimplantation of intercostal arteries is unnecessary or mandatory, and when reperfusion of intercostal arterie...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/s0741-5214(96)70267-7

    authors: Grabitz K,Sandmann W,Stühmeier K,Mainzer B,Godehardt E,Ohle B,Hartwich U

    更新日期:1996-02-01 00:00:00

  • Feasibility and validity of self-reported walking capacity in patients with intermittent claudication.

    abstract:OBJECTIVE:The primary aim of this study was to assess if self-reported measures of walking limitation correlate better with a community-based assessment of maximum walking distance (MWD) than they do with laboratory-based tests in patients with intermittent claudication. A secondary aim was to examine the effect of pri...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2012.02.073

    authors: Tew G,Copeland R,Le Faucheur A,Gernigon M,Nawaz S,Abraham P

    更新日期:2013-05-01 00:00:00

  • Treatment of portal venous thrombosis with selective superior mesenteric artery infusion of recombinant tissue plasminogen activator.

    abstract::Portal and mesenteric venous thrombosis is an uncommon condition that is usually treated with systemic anticoagulation. Catheter-directed thrombolysis via the superior mesenteric artery may be a viable adjunct to treatment of this potentially morbid condition. We present a case of portal and mesenteric venous thrombos...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/s0741-5214(03)01052-8

    authors: Henao EA,Bohannon WT,Silva MB Jr

    更新日期:2003-12-01 00:00:00

  • Developing a complex endovascular fenestrated and branched aortic program.

    abstract::In 2008, the top priority in our division's 5-year strategic plan was "to become an internationally recognized center of excellence for the endovascular treatment of complex aortic pathology extending from the aortic valve to the external iliac artery." Five components were identified as "most critical" to achieve thi...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2014.08.121

    authors: Schanzer A,Baril D,Robinson WP 3rd,Simons JP,Aiello FA,Messina LM

    更新日期:2015-03-01 00:00:00

  • Unusual surgical exposures to avoid scarred or infected standard access routes to the common femoral, deep femoral, and popliteal arteries.

    abstract::Standard approaches to lower extremity arteries may be rendered difficult or unusable because of scarring or infection, or both. This article describes unusual alternative approaches to facilitate lower extremity bypasses that would normally require approaches to the common femoral, deep femoral, or popliteal arteries...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2016.03.472

    authors: Veith FJ,Ascher E,Cayne NS

    更新日期:2016-10-01 00:00:00

  • The influence of gender on patency rates after iliac artery stenting.

    abstract:OBJECTIVE:The purpose of this study was to investigate the influence of gender on the long-term outcome after iliac artery stenting and to assess gender-specific differences of the influence of risk factors on treatment success and patency rates. METHODS:Between January 2000 and December 2006, 404 percutaneous translu...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2014.01.010

    authors: Bechter-Hugl B,Falkensammer J,Gorny O,Greiner A,Chemelli A,Fraedrich G

    更新日期:2014-06-01 00:00:00

  • Aortic mural thrombus: an occult source of arterial thromboembolism.

    abstract::During a 28-year period from 1955 to 1983, two cases of massive repetitive arterial thromboembolism from nonaneurysmal aortic mural thrombus were diagnosed antemortem and successfully corrected at the University of California, Los Angeles Medical Center. Within the same time period, 48 cases of nonaneurysmal aortic mu...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:

    authors: Machleder HI,Takiff H,Lois JF,Holburt E

    更新日期:1986-11-01 00:00:00

  • Surgical management of the patient with bilateral internal carotid artery occlusion.

    abstract::The patient with bilateral internal carotid artery occlusion is at high risk for development of stroke. Medical management and extracranial-intracranial bypass do not appear to offer these patients any protection from symptoms of cerebrovascular insufficiency. Our initial treatment in 11 of 12 patients who had this pa...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1067/mva.1987.avs0050715

    authors: Friedman SG,Lamparello PJ,Riles TS,Imparato AM,Sakwa MP

    更新日期:1987-05-01 00:00:00

  • Lower limb deep venous flow in patients with peripheral vascular disease.

    abstract:PURPOSE:A prospective controlled study was undertaken to determine how peripheral vascular disease (PVD) influences flow in the deep veins of the leg. METHODS:Eighty-nine patients with peripheral vascular disease and 35 age-matched control subjects were studied. The popliteal vein diameter and flow velocity were measu...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/s0741-5214(99)70247-8

    authors: Libertiny G,Hands L

    更新日期:1999-06-01 00:00:00

  • Off-the-shelf multibranched endograft for total endovascular repair of the aortic arch.

    abstract:OBJECTIVE:The goal of this study was to select branched endograft designs that could fit most aortic arch anatomies. Such off-the-shelf endografts, once available, would be an endovascular therapeutic option to consider in the acute setting and would shorten the design and manufacturing process. METHODS:We retrospecti...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jvs.2019.11.046

    authors: Bosse C,Kölbel T,Mougin J,Kratzberg J,Fabre D,Haulon S

    更新日期:2020-09-01 00:00:00

  • Incidence, etiology, and management of type III endoleak after endovascular aortic repair.

    abstract:OBJECTIVE:The objective of this study was to retrospectively assess the incidence, etiology, and management of type III endoleaks in a large cohort of patients treated with endovascular aneurysm repair (EVAR) in two European university centers. METHODS:From 1995 until 2014, 965 EVAR procedures were performed with use ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jvs.2017.01.056

    authors: Maleux G,Poorteman L,Laenen A,Saint-Lèbes B,Houthoofd S,Fourneau I,Rousseau H

    更新日期:2017-10-01 00:00:00

  • Frequency of cancer in patients operated on for acute peripheral arterial thrombosis and the impact on prognosis.

    abstract:OBJECTIVE:Little is known about acute peripheral arterial thrombosis in patients with concomitant cancer. Small studies suggest that revascularization in this patient group is associated with thrombosis and increased risk of amputation and death. We investigated the frequency of cancer in patients operated on for acute...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2015.06.223

    authors: Nicolajsen CW,Dickenson MH,Budtz-Lilly J,Eldrup N

    更新日期:2015-12-01 00:00:00

  • Multicenter prospective study of nonruptured abdominal aortic aneurysm. Part II. Variables predicting morbidity and mortality.

    abstract::A previous article (Part I) described the patient population and operative management of 666 patients who had surgery for nonruptured abdominal aortic aneurysms. This article details the perioperative complications and, by chi-square and logistic regression analysis, identifies the variables that are associated with e...

    journal_title:Journal of vascular surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1067/mva.1989.vs0090437

    authors: Johnston KW

    更新日期:1989-03-01 00:00:00

  • Tissue engineering applications to vascular bypass graft development: the use of adipose-derived stem cells.

    abstract::The burgeoning field of vascular tissue engineering holds promise for the creation of a practical and successful small-diameter arterial bypass graft. Many creative combinations of autologous cells and scaffolds exist along with an equally long list of microenvironmental cues used to create a functional arterial condu...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.jvs.2007.02.046

    authors: DiMuzio P,Tulenko T

    更新日期:2007-06-01 00:00:00