Thoracic aorta emergencies: is the endovascular treatment the new gold standard?

Détails

ID Serval
serval:BIB_7191FD0FE34E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Thoracic aorta emergencies: is the endovascular treatment the new gold standard?
Périodique
Interactive Cardiovascular and Thoracic Surgery
Auteur⸱e⸱s
Ferrari E., Tozzi P., von Segesser L.
ISSN
1569-9285[electronic]
Statut éditorial
Publié
Date de publication
12/2006
Volume
5
Numéro
6
Pages
730-734
Langue
anglais
Notes
Journal Article --- Old month value: Dec
Résumé
BACKGROUND: The endovascular treatment for acute traumatic aorta rupture has been proven to be safe in emergency. Technical aspects concerning the device fixation, the materials' durability, and the patients' selection criteria are still under discussion. We present our clinical experience and the mid-term follow-up. METHODS: Between January 2001 and January 2005, twenty-five patients have been diagnosed with acute traumatic aorta wall rupture in our emergency department. An angio computed tomography scan (CT-scan) was performed to confirm the diagnosis and to localize the aortic lesions. Eighteen patients with isolated intimal lesion, aorta wall hematoma or aorta wall tear up to 1/3 of the circumference, received the endovascular treatment. The intravascular ultrasound (IVUS) and the fluoroscopy control were used routinely. The procedure was considered to have succeeded in the case of complete aortic wall tear occlusion. A CT-scan follow-up was organized 1 week and 1 year after the procedure. RESULTS: Eighteen patients underwent endovascular treatment and 17 of these patients presented associated multiple injuries. The mean age was 40.7+/-12 years. The hospital mortality rate was 0%. In one patient the distal part of the graft was accidentally deployed into the brachiocephalic trunk and was surgically removed 8 weeks later. Two patients (11.1%) suffered from transitory neurological disturbances and 4 patients (22.2%) had the left subclavian artery ostia occluded by the graft, without developing symptoms. The mean follow-up time was 21+/-3 months: 1 patient (5.5%) died 1 month after the procedure for acute aortic rupture and no endoleaks were reported. CONCLUSIONS: The endovascular treatment for traumatic aortic rupture is an interesting alternative to conventional open surgery for a selected patient cohort. The stent graft material and the fixation to the normal aortic wall are safe and reliable in the mid-term. The results lead us to choose this approach as the treatment of choice in selected patients with traumatic aortic wall rupture.
Pubmed
Open Access
Oui
Création de la notice
28/01/2008 10:16
Dernière modification de la notice
20/08/2019 15:30
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