Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Clinical Analysis of TEVAR in Blunt Thoracic Aortic Injury

둔상에 의한 흉부대동맥 손상에서 TEVAR에 관한 임상연구

  • Ku, Gwan Woo (Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital) ;
  • Choi, Jin Ho (Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital) ;
  • Choi, Min Suk (Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital) ;
  • Park, Sang Soon (Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital) ;
  • Sul, Young Hoon (Department of Surgery, Eulji University Hospital) ;
  • Go, Seung Je (Department of Surgery, Eulji University Hospital) ;
  • Ye, Jin Bong (Department of Surgery, Eulji University Hospital) ;
  • Kim, Joong Suck (Department of Surgery, Eulji University Hospital) ;
  • Kim, Yeong Cheol (Department of Surgery, Eulji University Hospital) ;
  • Hwang, Jung Joo (Department of Trauma Surgery, Pusan National University Hospital Trauma Center)
  • 구관우 (을지대학교병원 흉부외과) ;
  • 최진호 (을지대학교병원 흉부외과) ;
  • 최민석 (을지대학교병원 흉부외과) ;
  • 박상순 (을지대학교병원 흉부외과) ;
  • 설영훈 (을지대학교병원 외과) ;
  • 고승제 (을지대학교병원 외과) ;
  • 예진봉 (을지대학교병원 외과) ;
  • 김중석 (을지대학교병원 외과) ;
  • 김영철 (을지대학교병원 외과) ;
  • 황정주 (부산대학교병원 외상외과)
  • Received : 2014.11.09
  • Accepted : 2015.12.09
  • Published : 2015.12.31
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Abstract

Purpose: Thoracic aortic injury is a life-threatening injury that has been traditionally treated by using surgical management. Recently, thoracic endovascular aortic repair (TEVAR) has been conducted pervasively as a better alternative treatment method. Therefore, this study will focus on analyzing the outcome of TEVAR in patients suffering from a blunt thoracic aortic injury. Methods: Of the blunt thoracic aortic injury patients admitted to Eulji University Hospital, this research focused on the 11 patients who had received TEVAR during the period from January 2008 to April 2014. Results: Seven of the 11 patients were male. At the time of admission, the mean systolic pressure was $105.64{\pm}24.60mm\;Hg$, and the mean heart rate was $103.64{\pm}20.02per$ minute. The median interval from arrival to repair was 7 (4, 47) hours. The mean stay in the ICU was $21.82{\pm}16.37hours$. In three patients, a chimney graft technique was also performed to save the left subclavian artery. In one patient, a debranching of the aortic arch vessels was performed. In two patients, the left subclavian artery was totally covered. In one patient whose proximal aortic neck length was insufficient, the landing zone was extended by using a prophylactic left subclavian artery to left common carotid artery bypass before TEVAR. There were no operative mortalities, but a patient who was covered of left subclavian artery died from ischemic brain injury. Complications such as migration, endovascular leakage, collapse, infection and thrombus did not occur. Conclusion: Our short-term outcomes of TEVAR for blunt thoracic aorta injury was feasible. Left subclavian artery may be sacrificed if the proximal landing zone is short, but several methods to continue the perfusion should be considered.

Keywords

References

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