Improving Surveillance of Traumatic Thoracic Aortic Injuries Repaired with Thoracic Endovascular Graft Placement. Am Surg 2018 Jul 01;84(7):1129-1132
Date
08/02/2018Pubmed ID
30064575Scopus ID
2-s2.0-85050888856 (requires institutional sign-in at Scopus site)Abstract
The optimal follow-up protocol for patients undergoing thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury remains unclear. The objective of this study was to assess follow-up patterns in such patients and present an approach to improve long-term follow-up in this cohort. The University of Louisville Trauma Registry was queried for patients who underwent TEVAR for traumatic thoracic aortic injuries between 2006 and 2016. Demographic, injury-specific, perioperative, and outcome measures were recorded for each patient. Follow-up evaluation and duration of follow-up were captured. Follow-up imaging was reviewed for any evidence of vascular complications. A total of 56 patients underwent TEVAR for traumatic thoracic aortic injury. Median age was 48 (range 18-86). Injury mechanism was largely blunt trauma (55 (98%)). Median injury severity score was 34 (range 17-43). Median length of stay was 12.5 days (range 1-40 days), and 51 patients (91%) survived to discharge. Of these, 30 (54%) made at least one follow-up appointment, and 21 of those 30 (70%) received a follow-up CT scan. Median time to last follow-up was one month (range 0-48 months), with 12 patients (21%) having follow-up beyond two months. No patients demonstrated any evidence of vascular complications on imaging at last follow-up. Despite the increased use of TEVAR to treat traumatic aortic injuries, limited follow-up data exist to predict the long-term outcomes of such interventions. Development of statewide or regional databases may help better track outcomes and identify late complications.
Author List
Ludwig NA, Bhutiani N, Linsky PL, Dwivedi AJ, Bozeman MCAuthor
Paul L. Linsky MD Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Aorta
Endovascular Procedures
Female
Follow-Up Studies
Hospitals, University
Humans
Length of Stay
Male
Middle Aged
Population Surveillance
Retrospective Studies
Risk Factors
Survival Analysis
Thoracic Injuries
Transplants
Treatment Outcome
Wounds, Nonpenetrating