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

Tevar is superior to open repair for blunt aortic injury
Download
1 / 12

  • 114 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

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.

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