Evolution of treatment for traumatic thoracic aortic injuries

Celis, Rolando; Park, Sun C.; Shukla, Ashutosh; Zenati, Mazen S.; Chaer, Rabih A.; Rhee, Robert Y.; Makaroun, Michel S.; Cho, Jae-Sung

doi:10.1016/j.jvs.2012.01.011

Cited by 14 publications

(16 citation statements)

References 26 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thoracic endovascular aortic repair (TEVAR) has emerged over the last decade as the preferential minimally invasive treatment for various thoracic aortic pathologies including traumatic thoracic aortic injuries (TTAI). [1][2][3][4] Although TEVAR for TTAI is effective, its durability remains a concern, especially in young patients. 5,6 Applications outside of physical conditions for which the thoracic aortic stent graft (TASG) was designed could result in device failure, 7 which may lead to distal end-organ malperfusion caused by aortic occlusion, endoleak, and reperfusion of the injured aorta or endograft infolding or collapse.…”

mentioning

confidence: 99%

Computer modeling for the prediction of thoracic aortic stent graft collapse

Pasta

Cho

Dur

et al. 2013

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

A potentially devastating complication that may occur after endovascular repair of traumatic thoracicaortic injuries is stent graft collapse. Although usually asymptomatic, stent graft collapse may be accompanied by adverse hemodynamic consequences. Numerous anatomic and device-related factors contribute to the development of collapse, but predictive factors have not yet been clearly defined. In the present study, we assessed the relevant hemodynamics and solid mechanics underlying stent graft collapse using a computational fluid-structure interaction framework of stent graft malapposition. Our findings suggest that both increased stent graft angle and extension into the aortic arch lead to a markedly increased transmural pressure across the stent graft wall, portending collapse. Patient-specific computational modeling may allow for identification of patients at high risk for collapse and aid in planning for an additional, prophylactic intervention to avert its occurrence.

show abstract

mentioning

confidence: 99%

Computer modeling for the prediction of thoracic aortic stent graft collapse

Pasta

Cho

Dur

et al. 2013

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“… 2 , 3 These usually occur after deceleration injury, are usually accompanied with significant injuries to other organs and are mostly fatal. 7 - 9 The main context is in high speed automobile crashes (>100 km/h) with a deceleration change in velocity of more than 32 km/h. 8 Most injuries to the aorta occurs with head on impact with side and rear impact occurring much less often.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary artery stenosis caused by a large aortic arch pseudoaneurysm detected 10 years after a minor trauma

Zamani

Aghasadeghi

Zarrabi

et al. 2016

J Cardiovasc Thorac Res

View full text Add to dashboard Cite

Pseudoaneurysm of aorta is a rare condition usually seen after aortic surgeries or serious accidents. Here we report a 60 years old man without any previous medical condition who presented with non-specific symptoms and underwent different investigations for more than 1 year, until the presence of a continuous murmur raised suspicion toward his cardiovascular system. In echocardiographic and computed tomography (CT) angiographic studies a large pseudoaneurysm of aortic arch with compression effect on pulmonary artery was detected. At this stage he remembered having suffered a minor trauma 10 years ago. He finally underwent operation and his aortic wall was repaired successfully with a patch. This case highlights the importance of thorough history taking and physical examination in patients irrespective of symptoms and high index of suspicion to detect this life-threatening condition.

show abstract

“…Similarly, Celis et al in 2012 reported the superiority of TEVAR over OR according to their experience in terms of favourable mortality rates, although the difference was borderline statistically insignificant (P = .06) [32]. Of 91 patients who presented with a traumatic aortic injury, 41 were treated operatively and the remaining 50 underwent TEVAR; mortality in the former group was higher (19.5% vs 6.0%) and overall morbidities incidence was similar between the two groups (42% vs 50% respectively).…”

Section: Evidencementioning

confidence: 92%

“…Of 91 patients who presented with a traumatic aortic injury, 41 were treated operatively and the remaining 50 underwent TEVAR; mortality in the former group was higher (19.5% vs 6.0%) and overall morbidities incidence was similar between the two groups (42% vs 50% respectively). Noteworthily, 2 patients in the OR group developed paraplegia postoperatively compared to none in the TEVAR group, and importantly, both ISS and comorbidities (hypertension, peripheral arterial disease, diabetes mellitus and coronary artery disease) were compared and found to be similar in the two groups [32].…”

Section: Evidencementioning

confidence: 99%