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Mid-term follow-up results of endovascular repair for Grade 3 blunt thoracic aortic injuries
Received:December 25, 2020  Revised:January 24, 2021  Click here to download the full text
Citation of this paper:LI Xu,ZHANG Wan,DING Yong,ZHOU Min,SHI Zhen-yu.Mid-term follow-up results of endovascular repair for Grade 3 blunt thoracic aortic injuries[J].Chinese Journal of Clinical Medicine,2021,28(2):204-209
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Author NameAffiliationE-mail
LI Xu Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
ZHANG Wan Department of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai 200040, China  
DING Yong Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
ZHOU Min Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
SHI Zhen-yu Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China shizhenyumax@163.com 
Abstract:Objective: To explore the mid-term follow-up results of thoracic endovascular aortic repair (TEVAR) for Grade 3 blunt thoracic aortic injuries (BTAI), and analyze the postoperative aortic dilatation based on the imaging of computed tomographic angiography (CTA).Methods: A total of 28 consecutive Grade 3 BTAI in patients treated with TEVAR in Zhongshan Hospital, Fudan University between July 2008 and June 2015. Trauma-related pseudoaneurysms and dissections were categorized into Grade 3 BTAI, mean follow-up time was 5.5 months. Endpoints were survival, reintervention, stent graft (SG)-related complications, and postoperative aortic remodeling and dilatation. The pre-operative and post-operative aorta diameters of different aspects were also recorded and compared.Results: Among 28 patients, 25 pseudoaneurysms and 3 dissections were recruited. There were 19 males and 9 females, the average age was (47.0±13.7) years old. All patients underwent delayed TEVAR with a median of 8 days after trauma. One patient died of pulmonary embolism 1 week after TEVAR. The technical success rate of TEVAR was 100.0%(28/28) and clinical success rate was 96.4%(27/28). Twenty-seven patients survived and were followed up. During this period, no stroke or endoleak occurred. No reintervention was performed although 14 SG-related complications (including 12 bird-beak configurations and 4 stenotic or occluded LSA) were observed. Aortic dilation was observed in ascending aorta at the bifurcation of pulmonary artery, descending aorta at the bifurcation of pulmonary artery, aortic bifurcation, but there was no significant difference between pre-operation and post-operation. Moreover, there was no correlation between aortic dilation and complications.Conclusions: TEVAR is safe and effective for thoracic aortic pseudoaneurysm and aortic dissection induced by BTAI.
keywords:blunt thoracic aortic injuries  thoracic endovascular aortic repair  aortic dissection
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