Διακρατικό ΠΜΣ Ενδαγγειακές Τεχνικές
Library of the School of Health Sciences

2018-06-27

2018

Kaselouris Konstantinos

Γερουλάκος Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χατζηιωάννου Αχιλλέας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κακίσης Ιωάννης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Απώτερα αποτελέσματα στην ενδαγγειακή αντιμετώπιση τραυματικών κακώσεων αορτής

Greek

Late results of endovascular repair in traumatic aortic injuries

Objective: Endovascular repair in traumatic aortic injury stands in practice for more than twenty years and most of the times represents the method of choice in aortic trauma. Concerns have been raised regarding late results of the method. The purpose of this review is to present published data of late (more than 5 years) outcomes.
Materials and Methods: A search of PUBMED database was performed using as key-words “(aortic or aorta) & (injury or injuries or trauma) & late & results” και “[(thoracic & endovascular) or TEVAR] & (trauma* or injur*)”. All papers that published any results regarding endovascular repair of traumatic aortic injury beyond 60 months and were in english language were selected. For processing reasons the selecetd papers were assigned to two groups, one group with patients who underwent thoracic endovascular aortic repair (TEVAR) for all aortic diseases including aortic trauma and a second group with patients who underwent TEVAR exclusively for traumatic aortic injury.
Results: Twenty seven (27) papers were initially identified for the first group of which sixteen (16) fulfilled the criteria set and included for systematic review while forty nine (49) and thirty one (31) were the numbers of papers for the second group selected respectively. In first group 3626 patients underwent TEVAR of whom 320 (8.8%) did for traumatic injury while in second group 957 patients were included. Early mortality was 7.6% and 5.8% in first group respectively and 6.1% in second group. Five year survival was estimated between 48-90% and 87-98.3% in first group and 75.3-90% in second while for ten years the estimated survival percentages were 36-68.3%, 80-98.3% and 77-96% respectively. The complications and interventions reported beyond 5 years were extremely rare in both groups (2/110, 1.8% και 5/171, 2.9%). Five case reports with results or incidents beyond 5 years are reported along with a brief result description of the studies that were not included in the systematic review.
Conclusions: Results between patients who underwent TEVAR for any aortic pathology are different compared to those with aortic trauma. Impressively good both early and late outcomes of TEVAR for traumatic aortic injury define it as the method of choice in these patients. Observed complications beyond 5 years are extremely rare in TEVAR. Further evaluation of the method is needed, with prospective studies, outcome results beyond 20 years and definition of appropriate follow-up protocols.

Health Sciences

Endovascular, Aortic, Injuries, Late, Trauma

No

0

Yes

155

62

File access is restricted.

https://pergamos.lib.uoa.gr/uoa/dl/object/2775812