Pulmonary Embolism After Endovascular Aortic Repair, a Retrospective Cohort Study

Aortoesophageal fistula (AEF) caused by esophageal cancer (EC) is a rare but life-threatening complication. However, the optimal management strategy remains undetermined. Previous cases have demonstrated that thoracic endovascular aortic repair (TEVAR) is effective for prophylactic management. In our study, we evaluated the management of AEF with elective TEVAR over salvage TEVAR. In our single-center retrospective cohort study, forty-seven patients with cT4M0 EC were included in this study, and we divided them into salvage (Group S) and elective (Group E) groups based on whether TEVAR was performed before the hemorrhagic AEF occurred. Our study outcomes included survival and complication rate after TEVAR. Group E showed better overall 90-day survival and aortic-event-free survival in 90-day and 180-day over Group S. More patients in Group E could receive subsequent chemoradiotherapy or esophagectomy. Significantly fewer AEF-related complications, including recurrent hemorrhagic events after TEVAR, hypoperfusion-related organ injury, and bloodstream infection, were noted in Group E. In patients with advanced EC-invading aorta, elective TEVAR offered an early overall and aortic-event-free survival benefit compared to salvage TEVAR. By reducing the AEF-related complications, elective TEVAR could provide more patients receiving subsequent curative-intent treatment.

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Bridging stent-graft fracture after branched endovascular aortic repair in a dual-center retrospective cohort study

Journal of Vascular Surgery ◽

10.1016/j.jvs.2021.08.053 ◽

2021 ◽

Author(s):

Stefano Gennai ◽

Gioele Simonte ◽

Mattia Migliari ◽

Giacomo Isernia ◽

Nicola Leone ◽

...

Keyword(s):

Cohort Study ◽

Stent Graft ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Endovascular Aortic Repair ◽

Aortic Repair ◽

Graft Fracture

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Syncope in pulmonary embolism: a retrospective cohort study

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-138677 ◽

2020 ◽

pp. postgradmedj-2020-138677

Author(s):

Craig Richmond ◽

Hannah Jolly ◽

Chris Isles

Keyword(s):

Pulmonary Embolism ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

District General Hospital ◽

Clinical Feature ◽

Pulmonary Angiogram ◽

Ct Pulmonary Angiogram ◽

Age Range ◽

Symptoms And Signs

ObjectiveTo determine the prevalence of syncope or collapse in pulmonary embolism (PE).MethodsA retrospective cohort study was conducted. We examined the frequency with which syncope or collapse (presyncope) occurred alone or with other symptoms and signs in an unselected series of 224 patients presenting to a district general hospital with PE between September 2012 and March 2016. Confirmation of PE was by CT pulmonary angiogram in each case.ResultsOur cohort of 224 patients comprised 97 men and 127 women, average age 66 years with age range of 21–94 years. Syncope or collapse was one of several symptoms and signs that led to a diagnosis of PE in 22 patients (9.8%) but was never the sole presenting feature. In descending order, these other clinical features were hypoxaemia (17 patients), dyspnoea (12), chest pain (9), tachycardia (7) and tachypnoea (7). ECG abnormalities reported to occur more commonly in PE were found in 13/17 patients for whom ECGs were available. Patients with PE presenting with syncope or collapse were judged to have a large clot load in 15/22 (68%) cases.ConclusionSyncope was a frequent presenting symptom in our study of 224 consecutive patients with PE but was never the sole clinical feature. It would be difficult to justify routine testing for PE in patients presenting only with syncope or collapse.

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