TY - JOUR
T1 - Timing of Intervention in Blunt Traumatic Aortic Injury Patients
T2 - Open Surgical versus Endovascular Repair
AU - Chen, Shao Wei
AU - Wang, Shang Yu
AU - Liao, Chien Hung
AU - Huang, Yao Kuang
AU - Liu, Kuo Sheng
AU - Lin, Pyng Jing
AU - Tsai, Feng Chun
AU - Ko, Po Jen
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015
Y1 - 2015
N2 - Background Thoracic endovascular aortic repair (TEVAR) is a rapidly evolving therapy in treating blunt traumatic aortic injury (TAI). However, currently there is no consensus among literature regarding the repair timing of TAI. Our experiences to manage TAI with comparison between open surgical and endovascular repair in repair timing and short-term outcomes are reported. Risk factors for postoperative mortality and morbidity are stratified. Methods Between January 2003 and February 2014, 63 consecutive patients who have suffered from TAI and underwent conventional open surgical or endovascular aortic repair were retrospectively reviewed in this study. The primary outcomes were in-hospital mortality, postoperative complication, and operation timing. All medical records regarding trauma mechanisms, concomitant injuries, intervention detail, and postoperative outcomes were reviewed and analyzed. Results Among the 63 patients (mean age, 37.9 years; 57 male), 23 underwent open repair (OR) and 40 underwent TEVAR for blunt TAI. The TEVAR group had more urgent operation (injury to repair <24 hr; 57.5% vs. 30.4%, P = 0.038) and shorter operative time (136.25 ± 54.48 min vs. 414.78 ± 212.24 min, P = 0.00) than the respective open surgical repair group. Postoperative mortality and morbidity analysis showed that the OR group had higher in-hospital mortality (30.4% vs. 7.5%; P = 0.029), more patients with acute renal failure in need of hemodialysis (17.4% vs. 2.3%; P = 0.038), and more post-operation infection (30.4% vs. 5%; P = 0.005) than the respective TEVAR group. The Multivariate analysis, of the 10 (15.88%) patients that died after the surgery, showed that the risk factors of hospital mortality were grade IV TAI (frank rupture). Conclusions For treating TAI, TEVAR has emerged as a quicker and safer treatment option than OR. The findings of this study support the use of TEVAR over OR for patients who suffered from TAI.
AB - Background Thoracic endovascular aortic repair (TEVAR) is a rapidly evolving therapy in treating blunt traumatic aortic injury (TAI). However, currently there is no consensus among literature regarding the repair timing of TAI. Our experiences to manage TAI with comparison between open surgical and endovascular repair in repair timing and short-term outcomes are reported. Risk factors for postoperative mortality and morbidity are stratified. Methods Between January 2003 and February 2014, 63 consecutive patients who have suffered from TAI and underwent conventional open surgical or endovascular aortic repair were retrospectively reviewed in this study. The primary outcomes were in-hospital mortality, postoperative complication, and operation timing. All medical records regarding trauma mechanisms, concomitant injuries, intervention detail, and postoperative outcomes were reviewed and analyzed. Results Among the 63 patients (mean age, 37.9 years; 57 male), 23 underwent open repair (OR) and 40 underwent TEVAR for blunt TAI. The TEVAR group had more urgent operation (injury to repair <24 hr; 57.5% vs. 30.4%, P = 0.038) and shorter operative time (136.25 ± 54.48 min vs. 414.78 ± 212.24 min, P = 0.00) than the respective open surgical repair group. Postoperative mortality and morbidity analysis showed that the OR group had higher in-hospital mortality (30.4% vs. 7.5%; P = 0.029), more patients with acute renal failure in need of hemodialysis (17.4% vs. 2.3%; P = 0.038), and more post-operation infection (30.4% vs. 5%; P = 0.005) than the respective TEVAR group. The Multivariate analysis, of the 10 (15.88%) patients that died after the surgery, showed that the risk factors of hospital mortality were grade IV TAI (frank rupture). Conclusions For treating TAI, TEVAR has emerged as a quicker and safer treatment option than OR. The findings of this study support the use of TEVAR over OR for patients who suffered from TAI.
UR - http://www.scopus.com/inward/record.url?scp=84952870805&partnerID=8YFLogxK
U2 - 10.1016/j.avsg.2015.06.073
DO - 10.1016/j.avsg.2015.06.073
M3 - 文章
C2 - 26256715
AN - SCOPUS:84952870805
SN - 0890-5096
VL - 29
SP - 1559
EP - 1566
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
IS - 8
ER -