One-year results of thoracic endovascular aortic repair for blunt thoracic aortic injury (RESCUE trial)

Khoynezhad, Ali; Donayre, Carlos E.; Azizzadeh, Ali; White, Rodney A.

doi:10.1016/j.jtcvs.2014.09.026

Cited by 44 publications

(27 citation statements)

References 26 publications

(42 reference statements)

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“…Left upper extremity ischemia, vertebrobasilar insufficiency and coronary steal are also rare complications that occur. Most patients with blunt thoracic aortic injury are young otherwise healthy patients that tolerate LSCA coverage with no issues [57,58]. For instance, the RESCUE trial presented 52 patients who underwent TEVAR BTAI; 20 required complete LSCA coverage and 9 required partial LSCA coverage.…”

Section: Complicationsmentioning

confidence: 99%

“…For instance, the RESCUE trial presented 52 patients who underwent TEVAR BTAI; 20 required complete LSCA coverage and 9 required partial LSCA coverage. Zero of these patients suffered any strokes or spinal cord injuries as a result and only 4 patients required LSCA revascularization [57]. If these complications arise, they can be treated with left carotid subclavian bypass.…”

Section: Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Blunt thoracic aortic injury – concepts and management

Mouawad¹,

Paulisin²,

Hofmeister³

et al. 2020

J Cardiothorac Surg

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Background: Blunt thoracic aortic injury, a life-threatening concern, remains the second most common cause of mortality among all non-penetrating traumatic injuries, second only to intracranial hemorrhage. Kinetic forces from the rapid deceleration are the impetus for the injury mechanism and are graded accordingly. Given the prevalence of trauma as a public health problem, contemporary management considerations are important. Main body: Blunt thoracic aortic injury may be fatal if not diagnosed and treated expeditiously. Endovascular options allow safe and effective management of these dangerous injuries. This paper describes the overview of blunt thoracic aortic trauma, the epidemiology, presentation, diagnosis, and treatment options with a focus on endovascular management. Conclusion: Blunt thoracic aortic injury requires a high index of suspicion based on mechanism of injury in the trauma population. Endovascular options have become the mainstay of blunt thoracic aortic injury treatment whenever feasible with satisfactory results and long-term outcomes.

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Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Blunt thoracic aortic injury – concepts and management

Mouawad¹,

Paulisin²,

Hofmeister³

et al. 2020

J Cardiothorac Surg

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“…31,35 Coverage of the left subclavian artery appears well tolerated in patients with BTAI, with low rates of stroke or need for subclavian revascularization. 10,41 After TEVAR, patients require standard clinical and radiographic follow-up, with imaging obtained before hospital discharge and at 1-, 6-, and 12-month intervals followed by annual surveillance thereafter. Open repair still has a role for patients with severe lesions not amenable to endovascular coverage or as salvage therapy after TEVAR 10,11 and is optimally performed with distal bypass.…”

Section: Lesion-directed Managementmentioning

confidence: 99%

Evolution of lesion-specific management of blunt thoracic aortic injury

Harris

Rabin

Starnes

et al. 2016

Journal of Vascular Surgery

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Developments in diagnosis and treatment have transformed the management of blunt thoracic aortic injuries (BTAIs). For patients in stable condition, treatment practice has shifted from early open repair to nonoperative management for low-grade lesions and routine delayed endovascular repair for more significant injuries. However, effective therapy depends on accurate staging of injury grade and stability to select patients for appropriate management. Recent developments in BTAI risk stratification enable lesion-specific management tailored to the patient and aortic lesion. This review summarizes advances in lesion assessment and treatment and proposes an integrated scheme for the modern management of BTAI.

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“…As the successor to the Talent Thoracic Stent Graft System (Medtronic), Valiant has been evaluated in a number of critical research studies specifically aimed at elucidating its feasibility, safety, and effectiveness in the thoracic aorta, all with satisfactory results: VALOR II (US IDE for descending thoracic aneurysms, n=160) [44,45], VIRTUE (European registry for all types of TBADs, n=100) [46–48], the VALIANT CAPTIVIA registry (mid- to high-risk all-comer cohort, n=100) [28], the RESCUE trial (blunt thoracic aortic injury, n=50) [49,50], and the Valiant Mona LSA first-in-human feasibility trial using a modified Valiant Captivia System with branching to allow LSA patency (US FDA IDE via the new Innovation Pathway, n=9) [51]. The VIRTUE registry was a prospective cohort study comparing 3 groups of TBADs: complicated acute (n=50), subacute (n=24), and chronic (n=26).…”

Section: The Us Dissection Trial 3-year Results Of Valiant Captivia Fmentioning

confidence: 99%

Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

Lim¹

2017

Korean J Thorac Cardiovasc Surg

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Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectively. The Valiant Captivia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.

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One-year results of thoracic endovascular aortic repair for blunt thoracic aortic injury (RESCUE trial)

Abstract: TEVAR has favorable early midterm outcomes in the treatment of blunt thoracic aortic injury, and remains the treatment modality of choice. Longevity of the stent grafts in this young patient population has yet to be established.

Cited by 44 publications

References 26 publications

Blunt thoracic aortic injury – concepts and management

Blunt thoracic aortic injury – concepts and management

Evolution of lesion-specific management of blunt thoracic aortic injury

Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

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