Endovascular Repair of a Traumatic Aortic Transection in a Pediatric Patient

Saad, Nael; Pegoli, Walter; Alfieris, George M.; Waldman, David L.

doi:10.1016/j.jvir.2007.01.002

Cited by 17 publications

(5 citation statements)

References 11 publications

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“…The endograft device was transferred to the new delivery system via previously described techniques and delivered under fluoroscopic guidance. 11,12 Poststent placement DSA evaluation confirmed expectations that two devices would be required. The second 20 Â 55 mm iliac limb extension device was transferred to the sheath, delivered to the thoracic aorta via the sheath, and deployed under fluoroscopic imaging.…”

Section: Case 2: Decision Process and Techniquesmentioning

confidence: 62%

Endovascular Stent Grafts in Urgent Blunt and Penetrating Thoracic Aortic Trauma

Kolbeck

Kaufman

2011

Semin intervent Radiol

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A traumatic thoracic aortic injury is fatal in the majority of cases. Surviving the aortic injury in addition to the myriad of associated trauma requires comprehensive medical management from many medical services. Balancing these services and coordinating the medical care requires free and open communication between services. Although one might assume a thoracic aortic injury takes precedence over other injuries, an organized plan of care in which the morbidity of the injury as well as the consequences of treatment of each injury helps provide an appropriate "rank order" in the treatment process. A patient with a thoracic aortic injury can be observed for several days while additional injuries are treated, as long as appropriate blood pressure controls are observed. The treatment order for multiple injuries must be reevaluated on a regular basis to adjust for changes in the overall clinical condition. This rank order to treatment and scheduled treatment plan allows for appropriate imaging, evaluation, and coordination of services in preparation for the placement of a thoracic aortic stent graft. The goal of treatment is to reduce the risk of aortic rupture and subsequent fatal hemorrhage. Choosing an open surgical repair versus an endovascular stent graft depends upon physician expertise and clinical status of the patient. In the appropriate clinical setting, endovascular repair of the thoracic aortic injury has become the treatment of choice at the authors' institution in patients with significant operative risks and extensive comorbid injuries. Specific characteristics of the injured aorta also dictate the type of endovascular device required for repair. Case reviews of a patient with blunt trauma and a patient with penetrating trauma used to demonstrate clinical parameters, imaging options, and details of stent graft choice and placement, are presented followed by a review of the literature.

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Section: Case 2: Decision Process and Techniquesmentioning

confidence: 62%

Endovascular Stent Grafts in Urgent Blunt and Penetrating Thoracic Aortic Trauma

Kolbeck

Kaufman

2011

Semin intervent Radiol

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“…5,7,8 Naturally, this approach has also been applied to the pediatric population. 9,10 In our patient, due to her closed head injury, open surgical repair with anticoagulation was not a viable option. The patient was kept in the ICU with tight systolic arterial blood pressure control.…”

Section: Discussionmentioning

confidence: 86%

“…10 In one series, 6% of the patients admitted for TAI were patients younger than 16 years of age. 3 Three patients underwent endovascular repair with aortas measuring 13 to 16 mm in diameter, similar to our patient.…”

Section: Discussionmentioning

confidence: 97%

Endovascular repair of traumatic aortic injury in a pediatric patient

Keyhani¹,

Estrera²,

Safi³

et al. 2009

Journal of Vascular Surgery

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We present the case of a 14-year-old girl who sustained a traumatic aortic injury (TAI) after a motor vehicle collision. Due to the severity of her associated injuries, she was not a candidate for open aortic repair. Available options for endovascular repair were very limited due to the small aortic diameter (14 mm). We performed a successful endovascular repair with an off-label use of an iliac limb prosthesis (Excluder, WL Gore, Flagstaff, Ariz). This case demonstrates the utility of an iliac limb prosthesis for endovascular repair of TAI in a child as a bridge to future open conversion.

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“…A thorough understanding of available devices is required to ensure proper device selection and deployment. A variety of available ancillary devices can be utilized successfully to treat various aortic trauma when standard aortic devices do not accommodate patient anatomy 10,11 as well as other vascular injuries when standard devices are not applicable.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy for Overcoming Challenges Presented With Blunt Abdominal Aortic Injury

Gilani

Saucedo-Crespo

Scott

et al. 2012

Vasc Endovascular Surg

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Blunt abdominal aortic injury (BAAI) is a rare and lethal injury requiring surgical management. Injury patterns can be complex and surgical strategy should accommodate specific case circumstances. Endovascular solutions appear appropriate and preferred in certain cases of BAAI, which, however, may not be applicable due to device limitations in regard to patient anatomy and limited operating room capability. However, endovascular therapy can be pursued with limited fluoroscopy capability and consumable availability providing a solution that is expeditious and effective for select cases of BAAI.

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Endovascular Repair of a Traumatic Aortic Transection in a Pediatric Patient

Cited by 17 publications

References 11 publications

Endovascular Stent Grafts in Urgent Blunt and Penetrating Thoracic Aortic Trauma

Endovascular Stent Grafts in Urgent Blunt and Penetrating Thoracic Aortic Trauma

Endovascular repair of traumatic aortic injury in a pediatric patient

Endovascular Therapy for Overcoming Challenges Presented With Blunt Abdominal Aortic Injury

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