Fontana Federico, Macchi Edoardo, Piacentino Filippo, Cardim Larissa Nocchi, Marchi Giuseppe De, Barbosa Fabiane, Piffaretti Gabriele, Novario Raffaele, Rampoldi Antonio Gaetano, Fugazzola Carlo
1 Department of Radiology, University of Insubria, Circolo Hospital, Varese, Italy.
2 Department of Radiology, Niguarda Ca'Granda Hospital, Milano, Italy.
Vasc Endovascular Surg. 2018 Jul;52(5):335-343. doi: 10.1177/1538574418765385. Epub 2018 Mar 25.
To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs).
We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination.
Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months).
Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.
评估因急性钝性创伤性胸主动脉损伤（BTTAI）接受胸主动脉腔内修复术（TEVAR）的患者的主动脉直径变化及长期结果。
我们回顾性评估了2000年10月至2014年11月期间因BTTAI接受TEVAR的23例患者，平均年龄39岁（范围：17 - 74岁）。所有患者在出院前均接受计算机断层血管造影（CTA）检查，作为后续随访检查的基线影像。评估技术成功率、总体生存率和并发症。此外，评估支架移植物外（支架移植物近端1 cm和远端1 cm）的主动脉直径以及支架移植物内（近端末端远端2 cm和远端末端近端2 cm）的主动脉直径。将CTA上的基线直径与最新可用的随访检查直径进行比较。
技术成功率为100%，平均随访65.4个月（范围：12 - 171个月）。无死亡病例，观察到23例与腔内移植物相关的并发症中有2例（8.7%）（分别为术后2个月和4个月出现1例支架移植物远端折叠和1例内漏）。记录到支架移植物近端或远端（平均分别为0.7和0.5 mm）或支架移植物内（近端和远端直径平均值均为0.5 mm）的主动脉直径增加（平均随访65.4个月，范围：12 - 171个月）。
BTTAI患者接受TEVAR后的主动脉扩张在长期随访中极小。血管内治疗是急性BTTAI的一种持久且安全的选择。
