National Trends of Thoracic Endovascular Aortic Repair versus Open Thoracic Aortic Repair in Pediatric Blunt Thoracic Aortic Injury

Annals of Vascular Surgery
Bima J HasjimCarlos Donayre

Abstract

Blunt thoracic aortic injury (BTAI) occurs in <1% of all trauma admissions. Thoracic endovascular aortic repair (TEVAR) has become the preferred treatment modality in adult patients with BTAI, but its use in pediatrics is currently not supported by device manufacturers and lacks United States Food and Drug Administration approval. We hypothesized that there would also be an increased use of TEVAR in the pediatric population, thus conferring a lower risk of mortality compared with open thoracic aortic repair (OTAR). The National Trauma Data Bank (2007-2015) was queried for patients ≤17 years with BTAI. The primary outcomes were the incidences of TEVAR and OTAR. Secondary outcome was risk of mortality in those undergoing intervention. A multivariable logistic regression model was used to determine the risk of mortality in OTAR versus TEVAR. We identified 650 pediatric BTAI patients with 159 (24.5%) undergoing intervention. Of these, 124 underwent TEVAR (78.0%) and 35 (22.0%) underwent OTAR. The rate of TEVAR steadily increased from 2007 to 2015 (15.4% vs. 27.1%, P < 0.001). Patients receiving OTAR and TEVAR had a similar injury severity score and rate of hypotension on admission (P > 0.05). Compared with OTAR, TEVAR patients had ...Continue Reading

Citations

Jan 4, 2020·The British Journal of Radiology·Neville W NicholasSapna Puppala
Aug 31, 2019·World Journal of Emergency Surgery : WJES·Yutaka KondoHideo Yasunaga
Oct 3, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Harit KapoorMarianna Zagurovskaya
Feb 5, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Raymond N HaddadSophie Malekzadeh-Milani
Mar 25, 2021·Aorta : Official Journal of the Aortic Institute at Yale-New Haven Hospital·Ahmet Can TopcuIlyas Kayacioglu
Mar 27, 2021·Journal of Pediatric Surgery Case Reports·Elizabeth M SinclairErica L Riedesel
Jan 7, 2022·Angiology·Ranjan DahalDebabrata Mukherjee

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