An IVUS-based approach to traumatic aortic rupture, with a look at the lesion from inside.

Détails

ID Serval
serval:BIB_2AC93E764206
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
An IVUS-based approach to traumatic aortic rupture, with a look at the lesion from inside.
Périodique
Journal of endovascular therapy
Auteur(s)
Marty B., Tozzi P., Ruchat P., Huber C., Doenz F., von Segesser L.K.
ISSN
1526-6028 (Print)
ISSN-L
1526-6028
Statut éditorial
Publié
Date de publication
10/2007
Peer-reviewed
Oui
Volume
14
Numéro
5
Pages
689-697
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To review a single-institution experience with endovascular repair of acute traumatic aortic rupture (ATAR) performed on an emergency basis using intravascular ultrasound (IVUS) exclusively as the navigation tool for stent-graft implantation (no arteriography).
Between September 1998 and November 2006, 26 consecutive patients (19 men; mean age 38+/-19 years, range 15 to 83) underwent endovascular repair of ATAR performed by a surgical team using IVUS and fluoroscopy for lesion characterization and stent-graft deployment guidance. Transesophageal echocardiography was routinely used in all patients to visualize the aortic lesion and rule out residual flow after device deployment. Sealing of the aortic tear was evaluated by postoperative contrast-enhanced computed tomography.
IVUS revealed an extensive disruption of the tunica intima and media (>180 degrees ) in 46% (12/26) of patients; the disruption was circumferential in 3 cases, with pseudocoarctation. The aortic diameter at the site of rupture measured 24+/-4 mm. Primary technical success was 92% (24/26); 1 persistent but small proximal endoleak and an intraoperative death (4% in-hospital mortality) from abdominal bleeding in an octogenarian accounted for the failures. Procedure-related complications (2, 8%) included the aforementioned endoleak and a minor stroke secondary to cerebral embolization. There was no paraplegia associated with the repairs.
Endovascular repair of acute traumatic aortic disruption yields promising results, with high technical success and minimal procedure-related morbidity. IVUS as the primary navigation tool for device implantation allows prompt endovascular setup, instant aortic measurements, and precise visualization of the aortic disruption.

Mots-clé
Adult, Aortic Rupture/diagnostic imaging, Aortic Rupture/etiology, Aortic Rupture/surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation/adverse effects, Blood Vessel Prosthesis Implantation/instrumentation, Echocardiography, Transesophageal, Emergency Medical Services, Female, Fluoroscopy, Humans, Male, Middle Aged, Stents, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Interventional, Wounds and Injuries/complications, Wounds and Injuries/diagnostic imaging, Wounds and Injuries/surgery
Pubmed
Web of science
Création de la notice
28/01/2008 9:39
Dernière modification de la notice
20/08/2019 13:10
Données d'usage