Endovascular stenting versus open surgery for thoracic aortic disease: Systematic review and meta-analysis of perioperative results

Walsh, Stewart R.; Tang, Tjun Yip; Sadat, Umar; Naik, J.; Gaunt, Michael E.; Jonathan, Robinson; Hayes, Paul D.; Varty, K.

doi:10.1016/j.jvs.2007.09.062

Cited by 224 publications

(123 citation statements)

References 38 publications

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“…The evidence for efficacy and safety has been mainly derived from large multicenter registries (9,10). Single center retrospective studies evaluating individual diseases within ATAS, have revealed better outcome compared with open surgery with regard to complicated type-B AD, aortic transection, and ruptured descending thoracic aneurysm (11)(12)(13)(14). The debate on timing of aortic intervention is currently ongoing.…”

Section: Discussionmentioning

confidence: 99%

Treatment of acute thoracic aortic syndromes using endovascular techniques

Uğuz¹,

Canyiğit²,

Hidiroğlu³

et al. 2016

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

Treatment of acute thoracic aortic syndromes using endovascular techniques

Uğuz¹,

Canyiğit²,

Hidiroğlu³

et al. 2016

Diagn Interv Radiol

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“…Desse modo, a perda sanguínea é bem menor do que a produzida com a cirurgia convencional, a aorta não precisa ser pinçada e a recuperação do paciente é mais rápida. Vários estudos prospectivos e randomizados estão sendo conduzidos no sentido de comparar a técnica convencional com a endovascular [5][6][7][8][9][10] 14 . Já no Brasil, apesar de não haverem muitos estudos multicêntricos comparativos, houve melhora significativa da morbidade e de complicações pós-operatórias no trauma torácico desde a adoção do tratamento endovascular 15,16 .…”

Section: Discussionunclassified

Tratamento endovascular de pseudoaneurisma de aorta torácica: relato de caso

Brito¹,

Martins²,

Júnior³

et al. 2010

J. vasc. bras.

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IntroduçãoO trauma tem sido apontado como a principal causa de morte na população adulta jovem no mundo, e o traumatismo torácico, em especial, tem se destacado em virtude de fatores vinculados aos avanços tecnológicos, aos meios de transporte cada vez mais rápidos e ao aumento da violência urbana [1][2][3] . O trauma de tórax pode ser classificado em fechado ou penetrante em função da abertura ou não da cavidade pleural. Qualquer um dos órgãos contidos na cavidade torácica pode ser atingido durante um trauma, dependendo do mecanismo, trajetória e magnitude deste 4 . Uma grave consequência do trauma de tórax é o pseudoaneurisma ou falso aneurisma de aorta, que é uma entidade clínica causada por ruptura de uma das camadas da parede arterial, podendo ser retida pelos tecidos vizinhos.Os autores apresentam um relato de caso de traumatismo torácico fechado e desaceleração brusca causados por colisão de automóvel que culminou com pseudoaneurisma de aorta torácica, optando-se por tratamento endovascular com implante de endoprótese no Serviço de Hemodinâmi-ca de Sorocaba. O interesse deste caso reside na raridade da incidência e da sobrevida dos pacientes com este tipo de lesão, visto que a maioria dos casos vai a óbito antes do atendimento hospitalar, e no bom resultado do tratamento devido ao emprego de nova técnica minimamente invasiva em comparação às técnicas de tratamento convencionais. Apresentação do casoPaciente do sexo masculino, 31 anos, vítima de acidente automobilístico, apresentou falta de ar inspiratória gradativa e sem fatores de melhora acompanhada de dor Não foram declarados conflitos de interesse associados à publicação deste artigo. Artigo submetido em 28.08.08, aceito em 26.11.08. RELATO DE CASO ResumoPaciente de 31 anos vítima de acidente automobilístico apresentou falta de ar inspiratória progressiva acompanhada de dor dissecante no tórax, de forte intensidade, sem irradiação; Glasgow 15 e ISS 26 (16 + 9 + 1); exames laboratoriais e radiográficos compatíveis com a normalidade. Foi operado de fratura de tíbia 1 dia depois, tendo recebido alta 3 dias depois da entrada no serviço. No entanto, foi piorando da falta de ar e da dor torácica, retornando para nova consulta 2 dias após a alta hospitalar. Foi realizada tomografia computadorizada helicoidal que revelou pseudoaneurisma de aorta torácica. Optou-se por tratamento endovascular com implante de endoprótese.Palavras-chave: Pseudoaneurisma, aorta torácica, traumatismos torácicos. AbstractA 31-year-old car accident victim was admitted with progressive inspiratory dyspnea, followed by intense dissecting thoracic pain, without any irradiation. The patient's Glasgow score was 15, while his ISS was 26 (16 + 9 + 1). Laboratory and radiographic results were normal. One day after hospital admission, the patient underwent surgery due to a fractured tibia, being discharged from hospital 3 days later. However, worsening shortness of breath and thoracic pain were observed and he returned to the hospital 2 days later. A helical computed tomography was done reve...

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“…In the past, TEVAR was positioned as the main treatment strategy for TAA or traumatic aortic transection after its clinical introduction in 1994 [16]. Various studies demonstrated that the minimally invasive procedure of TEVAR might allow rapid control of blood loss even in patients with hemodynamic instability [17,18], and that the perioperative morbidity of TEVAR during an urgent condition was significantly better than that of emergency open surgery [19]. After the usefulness of TEVAR in closing a fistula between the aorta and an adjacent organ was reported in 1996 [20], numerous promising results in its short-term effectiveness have encouraged its clinical use, and the indications of TEVAR have expanded to AEF.…”

Section: Etiologies Of Aorto-esophageal Fistulamentioning

confidence: 99%

Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature

Uno

Koike

Takahashi

et al. 2017

Clin J Gastroenterol

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Aorto-esophageal fistula (AEF) is a rare and lethal entity, and the difficulty of making diagnosis of AEF is well-known. As promising results in the short-term effectiveness of thoracic endovascular aortic repair (TEVAR) promote its usage, the occurrence of AEF after TEVAR (post-TEVAR AEF) increases as one of the major complications. Therefore, we provide a review concerning the management strategy of post-TEVAR AEF. Although its representative symptom was reported as the triad of mid-thoracic pain and sentinel hematemesis followed by massive hematemesis, the symptom-free interval between sentinel hemorrhage and massive exsanguination is unpredictable. However, the physiological condition represents a surgical contraindication. Accordingly, early diagnosis is important, but either CT or esophago-gastroduodenoscopy rarely depicts a typical image. The formation of post-TEVAR AEF might be associated with the infection of micro-organisms, which is uncontrollable with anti-biotic administration. The current first-line strategy is combination therapy as follows, (1) to control bleeding by TEVAR in the urgent phase, and (2) radical debridement and aortic/esophageal re-construction in the semi-urgent phase. In view of the high mortality and morbidity rate, it is proposed that the choice in treatment strategies might be affected by patient's condition, size of the wall defects and the etiology of AEF. Practically, we should keep in mind the importance of making an early diagnosis and, once a suspicious symptom has occurred in a patient with a history of TEVAR, the existence of post-TEVAR AEF should be suspected. A prospective registry together with more developed technologies will be needed to establish a future strategy.Keywords Aorto-esophageal fistula Á Thoracic endovascular aortic repair Á Thoracic aortic aneurysm Á Endoscopy Á Surgery Abbreviations

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Endovascular stenting versus open surgery for thoracic aortic disease: Systematic review and meta-analysis of perioperative results

Abstract: Endovascular thoracic aortic repair reduces perioperative mortality and neurological morbidity in patients with descending thoracic aortic aneurysms. There may be less benefit in other thoracic aortic conditions.

Cited by 224 publications

References 38 publications

Treatment of acute thoracic aortic syndromes using endovascular techniques

Treatment of acute thoracic aortic syndromes using endovascular techniques

Tratamento endovascular de pseudoaneurisma de aorta torácica: relato de caso

Management of aorto-esophageal fistula secondary after thoracic endovascular aortic repair: a review of literature

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