초록접수 현황
| 20F-003 | 포스터 발표 |
Evaluation of zone 2 thoracic endovascular aortic repair performed with and without prophylactic embolization of the left subclavian artery in patients with blunt traumatic aortic injury
Miju Bae¹, Sung Woon Chung¹, Chung Won Lee¹, Up Huh¹, Seon Hee Kim¹, Yeong-Dae Kim¹, Chang Ho Jeon², Hoon Kwon²
¹Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine Busan, Republic of Korea
²Department of Radiology, Pusan National University Hospital, Pusan National University College of Medicine Busan, Republic of Korea
Purpose : To report the authors’ experience of performing thoracic endovascular aortic repair (TEVAR) for zone 2 lesions after traumatic aortic injury (TAI).
Methods : This retrospective review included 10 patients who underwent zone 2 TEVAR after identification of aortic isthmus injury by computed tomographic angiography (CTA) upon arrival at a regional trauma center emergency room from 2016 to 2019. Patients were classified into 2 groups: those who underwent left subclavian artery (LSA) embolization concurrently with the main TEVAR procedure; and those in whom LSA embolization was not performed during the main procedure, but was planned as a bail-out if type II endoleak was noted on follow-up CTA images. Pre-procedural factors, procedure-related factors, and post-procedure prognosis were compared between the groups.
Results : There were no differences in pre-procedural factors, endoleak occurrence, and post-procedure prognosis (including mortality) between the 2 groups. The duration of the procedure was shorter in the non-LSA embolization group (61 min vs. 27 min, p = 0.012). During follow-up, type II endoleak did not occur in either group.
Conclusion : TEVAR was sufficiently safe for treating zone 2 lesions after TAI. When performing zone 2 TEVAR for TAI, it would be desirable to delay preventative LSA embolization until patients are stabilized, if there is no finding of endoleak on the completion aortography image taken after complete deployment of the stent graft, and to determine the necessity of later embolization based on follow-up CTA images.
Methods : This retrospective review included 10 patients who underwent zone 2 TEVAR after identification of aortic isthmus injury by computed tomographic angiography (CTA) upon arrival at a regional trauma center emergency room from 2016 to 2019. Patients were classified into 2 groups: those who underwent left subclavian artery (LSA) embolization concurrently with the main TEVAR procedure; and those in whom LSA embolization was not performed during the main procedure, but was planned as a bail-out if type II endoleak was noted on follow-up CTA images. Pre-procedural factors, procedure-related factors, and post-procedure prognosis were compared between the groups.
Results : There were no differences in pre-procedural factors, endoleak occurrence, and post-procedure prognosis (including mortality) between the 2 groups. The duration of the procedure was shorter in the non-LSA embolization group (61 min vs. 27 min, p = 0.012). During follow-up, type II endoleak did not occur in either group.
Conclusion : TEVAR was sufficiently safe for treating zone 2 lesions after TAI. When performing zone 2 TEVAR for TAI, it would be desirable to delay preventative LSA embolization until patients are stabilized, if there is no finding of endoleak on the completion aortography image taken after complete deployment of the stent graft, and to determine the necessity of later embolization based on follow-up CTA images.
첨부파일 : Figures.pptx
책임저자: Miju Bae
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine Busan, Republic of Korea
발표자: Miju Bae, E-mail : nabikr@naver.com