Tevar is superior to open repair for blunt aortic injury
This presentation is the property of its rightful owner.
Sponsored Links
1 / 12

TEVAR is Superior to Open Repair for Blunt Aortic Injury PowerPoint PPT Presentation


  • 92 Views
  • Uploaded on
  • Presentation posted in: General

TEVAR is Superior to Open Repair for Blunt Aortic Injury. Royce Calhoun, MD, Stephanie Mayberg, PA-C, Bill Pevec, MD, Danh Nguyen, PhD^, Lisa Mu^ J. Nilas Young, MD John Laird, MD o Division of Cardiothoracic Surgery o Division of Cardiology ^Department of Biostatistics

Download Presentation

TEVAR is Superior to Open Repair for Blunt Aortic Injury

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Tevar is superior to open repair for blunt aortic injury

TEVAR is Superior to Open Repair for Blunt Aortic Injury

Royce Calhoun, MD, Stephanie Mayberg, PA-C, Bill Pevec, MD, Danh Nguyen, PhD^, Lisa Mu^

J. Nilas Young, MD John Laird, MDo

Division of Cardiothoracic Surgery

oDivision of Cardiology

^Department of Biostatistics

University of California Davis Medical Center


Blunt aortic injury

Blunt Aortic Injury

  • 75% patients die at scene of accident

  • 5% are unstable and die shortly after accident

  • 25% of remainder die of other injuries

  • Traditional approach to repair has been emergent open repair

    • Paraplegia 2-19%, Mortality 15-35%

  • Current trend is appropriately timed urgent repair with an evolving endovascular role

    • Paraplegia 0%, Mortality 0-17%


Methods

Methods

  • Comparison of open repair vs. stent for TTAT

  • 1999 to 2011

  • First thoracic aortic stent was October 2005

  • Exclusively stent repair for last 4 years


Approach

Open

n=35

Thoracotomy, L groin 30

Partial bypass 24

Full bypass 7

DHCA 4

Thoracotomy, Gott shunt 1

Endograft

n=40

Femoral (cut down) 33

Iliac (RP with graft) 2

Infrarenal Aorta (4 RP, 1 Lap) 5

Approach


Stent graft results

Stent Graft Results

  • Stents Used

    • 7 TAG

    • 1 C-TAG

    • 17 Excluder Cuffs

    • 4 AneuRx Cuffs

    • 2 Talent

    • 9 TX2

  • 36/40 immediate technical success

  • 39/40technical success after re-interventions

  • Complete coverage of traumatic tear with no stent migration or endoleaks at most recent follow-up


Tevar is superior to open repair for blunt aortic injury

Case

  • 17 YO male, ejected from car

  • Intracranial bleed, multiple orthopedic injuries, splenic and liver lacerations

  • Bilateral severe pulmonary contusions

  • pO2 55 on 100% FIO2 with 20 PEEP

  • Comminuted aortic tear


Results

Results


Results1

Results


Major adverse events

Major Adverse Events


Conclusions

Conclusions

  • Endovascular stents for BAI can be performed safely with excellent short and mid-term results

  • Time from admission to intervention of BAI is increased in the stent group with no increased mortality

  • Stents for BAI are associated with decreased OR times and intraoperative blood transfusions compared to open


  • Login