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- Title
The impact of intravascular ultrasound on outcomes of endovascular repair of blunt traumatic aortic injury.
- Authors
Etheridge, James C; Ahanchi, S Sadie; Dexter, David J; Cain, Brandon C; Collins, Jay N; Panneton, Jean M
- Abstract
Introduction: Endovascular repair has become first-line therapy for traumatic aortic injury. Proper endograft sizing is critical to outcomes following traumatic aortic injury repair; however, the adequacy of standard imaging modalities for this purpose remains uncertain. We assessed the impact of intravascular ultrasound on outcomes of endovascular traumatic aortic injury repair. Methods: A retrospective review was conducted for all traumatic aortic injury patients from 2005 to 2015. Primary endpoints were 30-day aortic-related complications (aortic-related mortality, stroke, and spinal cord ischemia) and late device-related complications (collapse, migration, endoleak, and reintervention) over the duration of follow-up. Aortic measurements were calculated from three-dimensional-reconstructed computerized tomography studies and intravascular ultrasound images. Aortic remodeling was quantified by volume change between initial and first follow-up computerized tomography scans. Results: Twenty-five patients were included (mean age 41, 72% male). Intravascular ultrasound was used in 14 patients. No differences in demographics or injury characteristics were observed between intravascular ultrasound and non-intravascular ultrasound patients. Proximal neck diameter was 1.2 mm greater on intraoperative intravascular ultrasound than initial computerized tomography imaging (P =.048). Endograft oversizing in relation to initial computerized tomography was 25% in intravascular ultrasound patients versus 9% in non-intravascular ultrasound patients (P =.001). No significant differences in aortic-related complications were noted. Device-related complications occurred more frequently in the non-intravascular ultrasound group at a mean follow-up of 252 days (36.4% vs. 0%, P =.026). Aortic remodeling rate was 4.41 cm3/day in the intravascular ultrasound group versus 2.34 cm3/day in the non-intravascular ultrasound group (P =.256). Conclusions: Intravascular ultrasound significantly impacts endograft sizing and was associated with decreased device-related complications following endovascular traumatic aortic injury repair.
- Subjects
AORTA surgery; AORTA injuries; ENDOVASCULAR surgery; COMPUTED tomography; SURGICAL complications; TRANSPLANTATION of organs, tissues, etc.; ULTRASONIC imaging; THREE-dimensional imaging; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics
- Publication
Trauma, 2019, Vol 21, Issue 3, p208
- ISSN
1460-4086
- Publication type
Article
- DOI
10.1177/1460408618776333