Endovascular and open repair for blunt aortic injury, treated in one clinical institution in Brazil. A case series

Abstract

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.

Cardiology in Brazilian scientific journals: an overview

“…Selection of appropriate surgical candidates may substantially improve survival rates among these patients. Sincos et al [20] retrospectively analyzed and compared the results of conventional surgical repair and endovascular treatment of blunt aortic injury in 26 patients treated for blunt aortic injury. Twenty-six patients were included in the study, 5 treated with operative repair and 21 with endovascular treatment and found that 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.…”

Impact of Stent-Graft Oversizing on the Thoracic Aorta:Experimental Study in a Porcine Model

“…Thoracic endovascular aortic repair (TEVAR) with stent-grafts has lower mortality and paraplegia rates than open surgery, but long-term results are still awaited. 4–7…”

Pesquisas em pneumologia recentemente publicadas em revistas brasileiras

“…According to Sincos et al, (57) endovascular treatment is a safe method for repairing blunt aortic trauma, with immediate and mid-term results that were comparable to those obtained with surgical repair. No complications caused by the stent graft were identified during the follow-up period (mean, 33 months).…”