Timing of Intervention in Blunt Traumatic Aortic Injury Patients: Open Surgical versus Endovascular Repair

Shao Wei Chen, Shang Yu Wang, Chien Hung Liao, Yao Kuang Huang, Kuo Sheng Liu, Pyng Jing Lin, Feng Chun Tsai*, Po Jen Ko

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

14 引文 斯高帕斯(Scopus)

摘要

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.

原文英語
頁(從 - 到)1559-1566
頁數8
期刊Annals of Vascular Surgery
29
發行號8
DOIs
出版狀態已出版 - 2015

文獻附註

Publisher Copyright:
© 2015 Elsevier Inc.

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