Placement of endovascular stent-grafts for emergency repair of acute traumatic aortic rupture: a single-centre experience

Abstract

The aim of this retrospective study was to evaluate mid- and long-term results of endovascular stent-graft placement for emergency repair of acute traumatic thoracic aortic rupture. From 1996 through 2005, 22 consecutive patients (mean age: 38.7 years) underwent endovascular repair of acute traumatic thoracic aortic rupture located at the aortic isthmus in most cases. All patients were at high surgical risk due to severe associated injuries. The endografts were inserted via femoral or iliac artery access under fluoroscopic guidance. Follow-up was performed postinterventionally, at 6 and 12 months and yearly thereafter, and included clinical examination and computed tomography (CT) scans. Technical and clinical success rates were 86.3%. Mean follow-up was 31.7 months. Three patients developed early type I endoleak due to the inability of the rigid graft to adapt to the curved aortic contour. In two of them conversion to open surgery was necessary. One patient had late type I endoleak and died. No other complications were observed. The outcome was successful in most patients. The mid- and long-term results of our current study are promising. However, early type I endoleak represents a problem, especially in adolescent patients with a marked curvature of the aortic arch.

Neurological complications after left subclavian artery coverage during thoracic endovascular aortic repair: A systematic review and meta-analysis

“…9,11,12,18,24,25,[36][37][38][39][42][43][44] Fig 3). 6,9,11,12,[14][15][16][17][18][19][20][21][22][23][24][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][45][46][47][48] Again, there was no evidence of heterogeneity (Cochran Q, 10.74; P ϭ .99) or bias (Egger 0.10; P ϭ .50). However, no significant difference was noted in the risk of SCI with LSA coverage and preoperative revascularization compared with no LSA coverage (0.8% vs 2.7%, respectively; POR, 1.69; 95% CI, 0.56-5.15; P ...…”

Endovascular Stent-Graft or Open Surgical Repair for Blunt Thoracic Aortic Trauma: Systematic Review

“…Of the type I endoleaks, three resulted in the deaths mentioned earlier (38,53,58). Eleven were successfully treated with additional stent-grafts (22,54,55,62,66,67,71), one with an uncovered Palmaz stent (Cordis) (51), and two with balloon dilation (67). There were five cases of open conversion (39,63,66,71) and five cases of spontaneous thrombosis (29,34,38,42,74).…”

Factors Portending Endoleak Formation After Thoracic Aortic Stent-Graft Repair of Complicated Aortic Dissection

“…11,12 It has long been observed that severe angulation and curvature in the abdominal aorta can result in endoleaks when treating aneurysms. 13 Near the aortic arch, the geometry can be severely curved or angulated, rendering sealing of the PIT a challenge.…”