Endovascular and open repair for blunt aortic injury, treated in one clinical institution in Brazil. A case series
Carregando...
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2011
Título da Revista
ISSN da Revista
Título do Volume
Editora
HOSPITAL CLINICAS, UNIV SAO PAULO
Citação
CLINICS, v.66, n.2, p.267-274, 2011
Resumo
OBJECTIVE: The objective of this retrospective study is to analyze and compare the results of conventional surgical repair and endovascular treatment of blunt aortic injury over the past 8 years. METHODS: Twenty-eight patients (25 male; mean age, 35 years) were treated for blunt aortic injury between April 2001 and March 2009 in a university hospital in Brazil. Twenty-six patients were included in the study: five were treated with operative repair (OR) and 21 with endovascular treatment (TEVAR). Two patients were excluded from analysis: one was managed conservatively, and one was treated with endovascular treatment for chronic dissection related to aortic trauma. RESULTS: Mean age was lower in the OR group than in the endovascular treatment group (17.8 vs. 38 years, P = .003). There was one death in the OR group and four deaths in the endovascular treatment group. Mean follow-up for the overall group was 33.6 months, with 48.7 months (range 8-83 months) for the OR group, and 29.8 months (range 2-91 months) for the TEVAR group. Mean time elapsed from injury to repair was 23.4 hours (range 8-48 h, median 20 h) for the OR group and 30.3 hours (range 2-240 h, median 18 h) for the TEVAR group (P = .374). The duration of surgery was shorter in the endovascular treatment group (142 versus 237 minutes; P = .005). There were no significant differences with respect to the number of postoperative days requiring mechanical ventilation, duration of ICU stay or duration of hospital stay. CONCLUSION: In this retrospective analysis, endovascular treatment was a safe method for repair of blunt aortic trauma, with immediate and midterm results that were comparable to those results obtained with operative repair. No complications from the stent graft were identified during follow-up. Nevertheless, long-term follow-up is necessary to confirm the effectiveness of this treatment.
Palavras-chave
Aortic injury, Endovascular treatment, Midterm results, Surgical technique, Trauma
Referências
- Alsac JM, 2008, J VASC SURG, V48, P1369, DOI 10.1016/j.jvs.2008.07.019
- Tehrani HY, 2006, ANN THORAC SURG, V82, P873, DOI 10.1016/j.athoracsur.2006.04.012
- Demetriades D, 2008, J TRAUMA, V64, P561, DOI 10.1097/TA.0b013e3181641bb3
- Canaud L, 2008, J ENDOVASC THER, V15, P326, DOI 10.1583/08-2425.1
- Fabian TC, 1998, ANN SURG, V227, P666, DOI 10.1097/00000658-199805000-00007
- Azizzadeh A, 2009, J VASC SURG, V49, P1403, DOI 10.1016/j.jvs.2009.02.234
- FECZKO JD, 1992, J TRAUMA, V33, P846, DOI 10.1097/00005373-199212000-00009
- Xenos ES, 2008, J VASC SURG, V48, P1343, DOI 10.1016/j.jvs.2008.04.060
- Tang GL, 2008, J VASC SURG, V47, P671, DOI 10.1016/j.jvs.2007.08.031
- BOYD CR, 1987, J TRAUMA, V27, P370
- Idu MM, 2005, J ENDOVASC THER, V12, P503, DOI 10.1583/04-1515R.1
- PATE JW, 1995, WORLD J SURG, V19, P119
- Muhs BE, 2007, J VASC SURG, V45, P655, DOI 10.1016/j.jvs.2006.12.023
- Fabian TC, 1997, J TRAUMA, V42, P374, DOI 10.1097/00005373-199703000-00003
- Amabile P, 2004, J VASC SURG, V40, P873, DOI 10.1016/j.jvs.2004.08.053
- Sternbergh WC, 2004, J VASC SURG, V39, P20, DOI 10.1016/j.jvs.2003.09.022
- SMITH RS, 1986, AM J SURG, V152, P660, DOI 10.1016/0002-9610(86)90444-7
- Hoffer EK, 2008, J VASC INTERV RADIOL, V19, P1153, DOI 10.1016/j.jvir.2008.05.012
- Steinbauer MGM, 2006, J VASC SURG, V43, P609, DOI 10.1016/j.jvs.2005.11.045
- Mattox KL, 2008, J TRAUMA, V64, P570
- Fabian TC, 1998, ANN SURG, V227, P676, DOI 10.1097/00000658-199805000-00007
- Meredith W, 1997, J TRAUMA, V42, P380
- Lazar HL, 2009, ANN THORAC SURG, V87, P1582, DOI 10.1016/j.athoracsur.2008.09.012
- Lobato AC, 2000, J ENDOVASC THER, V7, P16, DOI 10.1583/1545-1550(2000)007<0016:IERFDT>2.3.CO;2
- Midgley PI, 2007, J VASC SURG, V46, P662, DOI 10.1016/j.jvs.2007.05.061
- Neschis DG, 2008, NEW ENGL J MED, V359, P1708, DOI 10.1056/NEJMra0706159
- Reed AB, 2006, J VASC SURG, V43, P684, DOI 10.1016/j.jvs.2005.12.006
- Schumacher H, 2006, SEMIN VASC SURG, V19, P48, DOI 10.1053/j.semvascsurg.2005.11008
- Svensson LG, 2008, ANN THORAC SURG, V85, pS1, DOI 10.1016/j.athoracsur.2007.10.099