Traumatic injury of the thoracic aorta treated with stent-graft: Is long-term CT angiography follow-up justified?

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

“…24 The most recent clinical practice guidelines of the Society for Vascular Surgery 3 report that opinions among committee members ''varied widely'' regarding imaging frequency and type, leaving no clear-cut guideline for follow-up imaging. Rimon and colleagues 25 reviewed 33 CTA examinations of 7 patients over a mean follow-up of 6.3 years. All stent grafts remained stable and devoid of complications.…”

“…The authors concluded that, given the durability of modern endovascular devices, routine CTA is not warranted and should be avoided after the initial years of follow-up. 25 Imaging modalities such as magnetic resonance angiography or time-of-flight MRI are valuable alternatives and should be strongly considered after the initial confirmatory CT scan. Including these in the postoperative surveillance protocol presents an opportunity to curtail radiation and nephrotoxic contrast administration.…”

The Evaluation of Aortic Diameter Changes During Long-Term Follow-Up After Endovascular Treatment of Acute Blunt Traumatic Thoracic Aortic Injuries

“…4,25 However, to date, there are few long-term results available in the literature (Table 5). 16,18 –21…”

“…5 Several studies provide short- or medium-term follow-up, 4 –15 while long-term results are still scarce. 16 –21 Long-term results are particularly important because, in most cases, patients are younger than 40 years of age. Since the aortic isthmus diameter physiologically increases approximately 1.5 mm per decade (nearly 10 mm from adolescence to senescence), 22 aortic growth may result in the onset of long-term complications (in particular, migration of the stent-graft and endoleak).…”

Aortic emergencies—diagnosis and treatment: a pictorial review

“…After stent graft implantation regular CT follow-up has to be performed. How often and until when have still not been ideally determined [ 19 ]. Since the young population is usually more at risk for traumatic aortic injury the radiation burden will be substantial over time, so MRA might be a reasonable alternative to CT [ 20 ].…”