Endovascular Treatment of Blunt Thoracic Aortic Injuries in Right Arch Vessel Anatomy

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.

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Endovascular treatment of complex aortic injuries 40 years after surgery for aortic coarctation

Journal of Vascular Surgery Cases and Innovative Techniques ◽

10.1016/j.jvscit.2018.02.013 ◽

2018 ◽

Vol 4 (2) ◽

pp. 181

Author(s):

Elena Caporali ◽

Jos C. Van Den Berg ◽

Enrico Ferrari

Keyword(s):

Endovascular Treatment ◽

Aortic Coarctation ◽

Aortic Injuries

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Endovascular Treatment of Traumatic Thoracic Aortic Injuries: Short- and Medium-term Follow-up

Annals of Vascular Surgery ◽

10.1016/j.avsg.2009.05.013 ◽

2010 ◽

Vol 24 (2) ◽

pp. 160-166 ◽

Cited By ~ 25

Author(s):

Valentín Fernandez ◽

Gaspar Mestres ◽

Jordi Maeso ◽

José Manuel Domínguez ◽

M. Carmen Aloy ◽

...

Keyword(s):

Endovascular Treatment ◽

Medium Term ◽

Aortic Injuries

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Endovascular Treatment of Traumatic Thoracic Aortic Injuries

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2009.01.012 ◽

2009 ◽

Vol 208 (4) ◽

pp. 510-516 ◽

Cited By ~ 23

Author(s):

Robert J. Feezor ◽

Philip J. Hess ◽

Tomas D. Martin ◽

Charles T. Klodell ◽

Thomas M. Beaver ◽

...

Keyword(s):

Endovascular Treatment ◽

Aortic Injuries

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Immediate Endovascular Repair for Descending Thoracic Aortic Transection Secondary to Blunt Trauma

Journal of Endovascular Therapy ◽

10.1177/152660280000700103 ◽

2000 ◽

Vol 7 (1) ◽

pp. 16-20 ◽

Cited By ~ 37

Author(s):

Armando C. Lobato ◽

Rhonda C. Quick ◽

Bradley Phillips ◽

Mitar Vranic ◽

Julio Rodriguez-Lopez ◽

...

Keyword(s):

Endovascular Treatment ◽

Blunt Trauma ◽

Thoracic Aorta ◽

Endovascular Repair ◽

Motor Vehicle ◽

Motor Vehicle Collision ◽

Vehicle Collision ◽

Aortic Injuries ◽

Aortic Transection

Purpose: To report the immediate endovascular treatment of a thoracic aortic tear secondary to blunt trauma. Methods and Results: A 39-year-old man was injured in a motor vehicle collision. In addition to significant trauma to the head, chest, and abdomen, there were signs of a deceleration injury to the thoracic aorta. After urgent celiotomy to repair a lacerated spleen, the thoracic aortic transection was treated intraluminally using an endograft made of Gianturco Z-stents covered with polytetrafluoroethylene. The patient recovered from his injuries, and the thoracic endograft shows no evidence of endoleak 7 months after treatment. Conclusions: Endoluminal techniques can be used successfully in the immediate repair of thoracic aortic injuries.

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Early Outcome of Endovascular Treatment of Acute Traumatic Aortic Injuries: The Talent Thoracic Retrospective Registry

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2009.06.026 ◽

2009 ◽

Vol 88 (4) ◽

pp. 1258-1263 ◽

Cited By ~ 16

Author(s):

Marek P. Ehrlich ◽

Hervé Rousseau ◽

Robin Heijman ◽

Philippe Piquet ◽

Jean-Paul Beregi ◽

...

Keyword(s):

Endovascular Treatment ◽

Early Outcome ◽

Aortic Injuries

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Endovascular treatment of acute traumatic thoracic aortic injuries: A retrospective analysis of 20 cases

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2008.10.057 ◽

2009 ◽

Vol 138 (5) ◽

pp. 1129-1138 ◽

Cited By ~ 21

Author(s):

Francesca Urgnani ◽

Philip Lerut ◽

Marcio Da Rocha ◽

Domingo Adriani ◽

Fernando Leon ◽

...

Keyword(s):

Endovascular Treatment ◽

Retrospective Analysis ◽

Aortic Injuries

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Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽

10.1024/0301-1526.34.4.217 ◽

2005 ◽

Vol 34 (4) ◽

pp. 217-223 ◽

Cited By ~ 11

Author(s):

Diehm ◽

Schmidli ◽

Dai-Do ◽

Baumgartner

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Medical Treatment ◽

Endovascular Treatment ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Current Evidence ◽

Significant Morbidity ◽

Abdominal Aortic ◽

Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

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Anticoagulation in addition to dual antiplatelet therapy has no impact on long-term follow-up after endovascular treatment of (sub)acute lower limb ischemia

VASA ◽

10.1024/0301-1526/a000786 ◽

2019 ◽

Vol 48 (4) ◽

pp. 321-329

Author(s):

Mariya Kronlage ◽

Erwin Blessing ◽

Oliver J. Müller ◽

Britta Heilmeier ◽

Hugo A. Katus ◽

...

Keyword(s):

Endovascular Treatment ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Limb Ischemia ◽

Bleeding Complications ◽

Severe Bleeding ◽

Short Term ◽

Long Term Follow Up

Summary. Background: To assess the impact of short- vs. long-term anticoagulation in addition to standard dual antiplatelet therapy (DAPT) upon endovascular treatment of (sub)acute thrombembolic occlusions of the lower extremity. Patient and methods: Retrospective analysis was conducted on 202 patients with a thrombembolic occlusion of lower extremities, followed by crirical limb ischemia that received endovascular treatment including thrombolysis, mechanical thrombectomy, or a combination of both between 2006 and 2015 at a single center. Following antithrombotic regimes were compared: 1) dual antiplatelet therapy, DAPT for 4 weeks (aspirin 100 mg/d and clopidogrel 75 mg/d) upon intervention, followed by a lifelong single antiplatelet therapy; 2) DAPT plus short term anticoagulation for 4 weeks, followed by a lifelong single antiplatelet therapy; 3) DAPT plus long term anticoagulation for > 4 weeks, followed by a lifelong anticoagulation. Results: Endovascular treatment was associated with high immediate revascularization (> 98 %), as well as overall and amputation-free survival rates (> 85 %), independent from the chosen anticoagulation regime in a two-year follow up, p > 0.05. Anticoagulation in addition to standard antiplatelet therapy had no significant effect on patency or freedom from target lesion revascularization (TLR) 24 months upon index procedure for both thrombotic and embolic occlusions. Severe bleeding complications occurred more often in the long-term anticoagulation group (9.3 % vs. 5.6 % (short-term group) and 6.5 % (DAPT group), p > 0.05). Conclusions: Our observational study demonstrates that the choice of an antithrombotic regime had no impact on the long-term follow-up after endovascular treatment of acute thrombembolic limb ischemia whereas prolonged anticoagulation was associated with a nominal increase in severe bleeding complications.

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Gender differences in abdominal aortic aneurysm therapy – a systematic review

VASA ◽

10.1024/0301-1526/a000703 ◽

2018 ◽

Vol 47 (4) ◽

pp. 267-272 ◽

Cited By ~ 9

Author(s):

Konstanze Stoberock ◽

Tilo Kölbel ◽

Gülsen Atlihan ◽

Eike Sebastian Debus ◽

Nikolaos Tsilimparis ◽

...

Keyword(s):

Gender Differences ◽

Abdominal Aortic Aneurysm ◽

Survival Rate ◽

Aortic Aneurysm ◽

Endovascular Treatment ◽

Aortic Aneurysms ◽

Lower Survival Rate ◽

Lower Survival ◽

Abdominal Aortic ◽

Risk Of Rupture

Abstract. This article analyses if and to what extent gender differences exist in abdominal aortic aneurysm (AAA) therapy. For this purpose Medline (PubMed) was searched from January 1999 to January 2018. Keywords were: “abdominal aortic aneurysm”, “gender”, “prevalence”, “EVAR”, and “open surgery of abdominal aortic aneurysm”. Regardless of open or endovascular treatment of abdominal aortic aneurysms, women have a higher rate of complications and longer hospitalizations compared to men. The majority of studies showed that women have a lower survival rate for surgical and endovascular treatment of abdominal aneurysms after both elective and emergency interventions. Women receive less surgical/interventional and protective medical treatment. Women seem to have a higher risk of rupture, a lower survival rate in AAA, and a higher rate of complications, regardless of endovascular or open treatment. The gender differences may be due to a higher age of women at diagnosis and therapy associated with higher comorbidity, but also because of genetic, hormonal, anatomical, biological, and socio-cultural differences. Strategies for treatment in female patients must be further defined to optimize outcome.

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