Late Radiological and Clinical Outcomes of Traumatic Thoracic Aortic Injury Managed with Thoracic Endovascular Aortic Repair
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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.
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.
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.
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.
KeywordsComputerize Tomographic Angiography Stent Graft Thoracic Aortic Aneurysm Aortic Injury Thoracic Endovascular Aortic Repair
We would like to thank the vascular surgeons, cardiothoracic surgeons, and interventional radiologists who contributed to the New Zealand Thoracic Aortic Stent Registry.
- 15.Chiesa R, Tshomba Y, Kahlberg A et al (2010) Management of thoracic endograft infection. J Cardiovasc Surg 51:15–31Google Scholar
- 20.Erbel R, Aboyans V, Boileau C et al (2014) ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 35:2873–2926CrossRefPubMedGoogle Scholar
- 31.Marone EM, Kahlberg A, Tshomba Y et al (2013) Single-center experience with endovascular treatment of acute blunt thoracic aortic injuries. J Cardiovasc Surg 54:123–131Google Scholar