Cecile Martin1, Frederic Thony2, Mathieu Rodiere2, Pierre Bouzat3, Pierre Lavagne3, Michel Durand4, Olivier Chavanon1,5. 1. Thoracic and Vascular Centre, Cardiac Surgery Clinic, Grenoble University Hospital, Grenoble, France. 2. Central Radiology and Medical Imaging Service, Grenoble University Hospital, Grenoble, France. 3. Surgical Polyvalent Intensive Care Unit, Grenoble University Hospital, Grenoble, France. 4. Cardiovascular and Thoracic Intensive Care Unit, Grenoble University Hospital, Grenoble, France. 5. HP2 Laboratory, Université Grenoble Alpes, Grenoble, France.
Abstract
Objectives: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. Methods: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft. Results: In total, 48 men (80%) were included; the average age was 43 ± 17 years [17; 79]. The median time between the accident and endovascular repair was 6 h. Endovascular repair was successful in all cases with no cerebrovascular or paraplegia after treatment. Seventeen patients (27.3%) received a total coverage of the left subclavian artery; one of them received a subclavian carotid bypass. Mean follow-up was 5 years with a maximum of 14 years. There was no repeat surgery related to the aorta during follow-up. No stent graft failure, neurological or ischaemic event related to the stent graft was noted. One patient had a type 1 endoleak without any reintervention. The survival rate was 86.5% in 1 year, 81.6% in 5 years and 75.3% in 10 years. Conclusions: Treatment of injuries of the aortic isthmus with stent graft seems to be a safe long-term technique; we did not notice any event related to the stent graft during the follow-up.
Objectives: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. Methods: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft. Results: In total, 48 men (80%) were included; the average age was 43 ± 17 years [17; 79]. The median time between the accident and endovascular repair was 6 h. Endovascular repair was successful in all cases with no cerebrovascular or paraplegia after treatment. Seventeen patients (27.3%) received a total coverage of the left subclavian artery; one of them received a subclavian carotid bypass. Mean follow-up was 5 years with a maximum of 14 years. There was no repeat surgery related to the aorta during follow-up. No stent graft failure, neurological or ischaemic event related to the stent graft was noted. One patient had a type 1 endoleak without any reintervention. The survival rate was 86.5% in 1 year, 81.6% in 5 years and 75.3% in 10 years. Conclusions: Treatment of injuries of the aortic isthmus with stent graft seems to be a safe long-term technique; we did not notice any event related to the stent graft during the follow-up.
Authors: Dennis Hundersmarck; Quirine M J van der Vliet; Lotte M Winterink; Luke P H Leenen; Joost A van Herwaarden; Constantijn E V B Hazenberg; Falco Hietbrink Journal: Eur J Trauma Emerg Surg Date: 2020-07-06 Impact factor: 2.374