Timing of repair of blunt thoracic aortic injuries in the thoracic endovascular aortic repair era.

Journal of Vascular Surgery
Abdul Q AlarhayemRamon F Cestero

Abstract

Thoracic endovascular aortic repair (TEVAR) is the preferred operative treatment of blunt thoracic aortic injuries (BTAIs). Its use is associated with improved outcomes compared with open surgical repair and nonoperative management. However, the optimal time from injury to repair is unknown and remains a subject of debate across different societal practice guidelines. The purpose of this study was to evaluate national trends in the management of BTAI, with a specific focus on the impact of timing of repair on outcomes. Using the National Trauma Data Bank, we identified adult patients with BTAI between 2012 and 2017. Patients with prehospital or emergency department cardiac arrest or incomplete data sets were excluded from analysis. Patients were classified according to timing of repair: group 1, <24 hours; and group 2, ≥24 hours. The primary outcome evaluated was in-hospital mortality; secondary outcomes included overall hospital and intensive care unit length of stay. Multivariable logistic regression was performed to identify independent predictors of mortality. The analysis was completed for 2821 patients who underwent TEVAR for BTAI with known operative times. The overall mortality in the patient cohort was 8.4% (238/2821);...Continue Reading

References

Oct 17, 2008·The New England Journal of Medicine·David G NeschisBartley P Griffith
Nov 15, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·R FattoriR Di Bartolomeo
Oct 13, 2014·The Journal of Thoracic and Cardiovascular Surgery·G Chad Hughes
Mar 11, 2015·The Journal of Trauma and Acute Care Surgery·Joseph J DuBoseUNKNOWN Aortic Trauma Foundation
May 26, 2017·The Journal of Trauma and Acute Care Surgery·Steven R ShackfordWilliam A Teeter
Jan 11, 2019·Journal of the American College of Surgeons·Thomas M ScaleaJonathan J Morrison
Mar 30, 2019·Journal of Vascular Surgery·Elina QuirogaNiten Singh

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Citations

Sep 24, 2020·The Journal of Cardiovascular Surgery·Ilenia D'alessioSanti Trimarchi
Dec 22, 2020·Journal of the American College of Surgeons·Benjamin R ZambettiLouis J Magnotti
Jul 14, 2021·Der Unfallchirurg·R M BenzH von Tengg-Kobligk

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