M Khashram1, Q He2, T H Oh3, A Khanafer2, I A Wright4, T M Vasudevan4, A S N Lo5, J A Roake2, I Civil6. 1. Department of Vascular Endovascular & Transplant Surgery, Christchurch Hospital, Christchurch, New Zealand. manar.khashram@gmail.com. 2. Department of Vascular Endovascular & Transplant Surgery, Christchurch Hospital, Christchurch, New Zealand. 3. Department of Cardiothoracic Surgery, Auckland City Hospital, Auckland, New Zealand. 4. Department of Vascular Surgery, Waikato Hospital, Hamilton, New Zealand. 5. Department of Vascular Surgery, Wellington Regional Hospital, Wellington, New Zealand. 6. Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand.
Abstract
PURPOSE: Patients treated with thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury (TTAI) are often young and data on long-term durability of this treatment is not widely documented. The aims of this study were to report the New Zealand (NZ) national experience of TEVAR and to assess the durability of late outcomes and radiological follow-up of patients treated for TTAI. METHODS: Consecutive patients treated with TEVAR during a 12-year period from all tertiary centers in NZ were included. Early (30-day), late survival and radiological imaging data were recorded to document late graft-related complications and re-interventions. RESULTS: 88 patients with a median (range) age of 35 (15-87) year and 63 (71.6 %) males were included. Eleven patients (12.5 %) died within 30 days, of which three were aortic related deaths. The median (range) follow-up was 76.3 (0.3-164.6) months. Six (7.8 %) patients died during the follow-up period due to non-aortic-related causes. Nine (11.5 %) patients were lost to follow-up of which three emigrated overseas. Of those on surveillance, two patients required TEVAR re-intervention to previously treated aortic segments; one for a type 1b endoleak and the other for a symptomatic pseudo-coarctation. Both were treated successfully with a TEVAR. CONCLUSIONS: This multicenter study suggests that TEVAR is a durable option for treatment of traumatic thoracic aortic injury. Although, stent graft complications were uncommon, but when it occurred, it leads to re-intervention. Further radiological follow-up is required particularly in young patient to document late aortic/stent complications.
PURPOSE:Patients treated with thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury (TTAI) are often young and data on long-term durability of this treatment is not widely documented. The aims of this study were to report the New Zealand (NZ) national experience of TEVAR and to assess the durability of late outcomes and radiological follow-up of patients treated for TTAI. METHODS: Consecutive patients treated with TEVAR during a 12-year period from all tertiary centers in NZ were included. Early (30-day), late survival and radiological imaging data were recorded to document late graft-related complications and re-interventions. RESULTS: 88 patients with a median (range) age of 35 (15-87) year and 63 (71.6 %) males were included. Eleven patients (12.5 %) died within 30 days, of which three were aortic related deaths. The median (range) follow-up was 76.3 (0.3-164.6) months. Six (7.8 %) patients died during the follow-up period due to non-aortic-related causes. Nine (11.5 %) patients were lost to follow-up of which three emigrated overseas. Of those on surveillance, two patients required TEVAR re-intervention to previously treated aortic segments; one for a type 1b endoleak and the other for a symptomatic pseudo-coarctation. Both were treated successfully with a TEVAR. CONCLUSIONS: This multicenter study suggests that TEVAR is a durable option for treatment of traumatic thoracic aortic injury. Although, stent graft complications were uncommon, but when it occurred, it leads to re-intervention. Further radiological follow-up is required particularly in young patient to document late aortic/stent complications.
Authors: Raimund Erbel; Victor Aboyans; Catherine Boileau; Eduardo Bossone; Roberto Di Bartolomeo; Holger Eggebrecht; Arturo Evangelista; Volkmar Falk; Herbert Frank; Oliver Gaemperli; Martin Grabenwöger; Axel Haverich; Bernard Iung; Athanasios John Manolis; Folkert Meijboom; Christoph A Nienaber; Marco Roffi; Hervé Rousseau; Udo Sechtem; Per Anton Sirnes; Regula S von Allmen; Christiaan J M Vrints Journal: Eur Heart J Date: 2014-08-29 Impact factor: 29.983
Authors: Marcus R Kret; Amir F Azarbal; Erica L Mitchell; Timothy K Liem; Gregory J Landry; Gregory L Moneta Journal: J Vasc Surg Date: 2013-03-07 Impact factor: 4.268