Endovascular repair of traumatic thoracic aortic injury: Final results from the relay endovascular registry for thoracic disease

Burkhart Zipfel, Roberto Chiesa, Andrea Kahlberg, Enrico Maria Marone, Herve Rousseau, Ioannis Kaskarelis, Vincent Riambau, Gioacchino Coppi, Carlo Ferro, Carlo Sassi, Carlos Esteban, Nicola Mangialardi, Domenico G. Tealdi, Giovanni Nano, Maria Schoder, Martin Funovics, Semih Buz, Roland Hetzer

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background In blunt thoracic aortic injury, thoracic endovascular aortic repair (TEVAR) offers a less invasive alternative to open chest surgery. New reliable and accurate stent grafts have widened the endovascular treatment options. We report our experience with the Relay stent graft Bolton Medical, Sunrise, FL; Barcelona, Spain) for treatment of this injury. Methods Relay Endovascular Registry for Thoracic Disease (RESTORE) is a multicenter, prospective European registry, which enrolled patients treated with the Relay stent graft for thoracic aortic diseases from April 2005 to January 2009. Regular follow-up examinations were conducted for up to 24 months. This paper analyzes the cohort of patients treated for traumatic aortic injury. Results Forty adult trauma patients from 12 European centers underwent TEVAR. Mean age was 40 years and 34 patients were male. The proximal landing zone involved aortic arch zones 1 to 2 in 40% and zone 3 in 55% of procedures. Technical success was achieved in all cases. One (2.5%) patient suffered a rupture of the iliac artery. No patient developed procedure-related paraplegia or required conversion to open surgery. Follow-up imaging demonstrated complete exclusion of the traumatic tear and regression of the false aneurysms without endoleak or graft infolding. One late device-related complication was reported; penetration of the distal end of the stent graft treated by stent-graft extension. Thirty-day mortality was 2.5 % (n = 1), and late mortality 2.5% due to a secondary accident. Actuarial 2-year survival was 93.7%. Conclusions Thoracic endovascular aortic repair with the Relay stent graft is a safe and effective treatment for patients with traumatic aortic injury.

Original languageEnglish
Pages (from-to)774-780
Number of pages7
JournalAnnals of Thoracic Surgery
Volume97
Issue number3
DOIs
Publication statusPublished - Mar 2014

Fingerprint

Thoracic Diseases
Thoracic Injuries
Registries
Stents
Transplants
Thorax
Wounds and Injuries
Conversion to Open Surgery
Endoleak
Aortic Diseases
Nonpenetrating Wounds
Mortality
Iliac Artery
Paraplegia
False Aneurysm
Tears
Thoracic Aorta
Spain
Accidents
Rupture

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Endovascular repair of traumatic thoracic aortic injury : Final results from the relay endovascular registry for thoracic disease. / Zipfel, Burkhart; Chiesa, Roberto; Kahlberg, Andrea; Marone, Enrico Maria; Rousseau, Herve; Kaskarelis, Ioannis; Riambau, Vincent; Coppi, Gioacchino; Ferro, Carlo; Sassi, Carlo; Esteban, Carlos; Mangialardi, Nicola; Tealdi, Domenico G.; Nano, Giovanni; Schoder, Maria; Funovics, Martin; Buz, Semih; Hetzer, Roland.

In: Annals of Thoracic Surgery, Vol. 97, No. 3, 03.2014, p. 774-780.

Research output: Contribution to journalArticle

Zipfel, B, Chiesa, R, Kahlberg, A, Marone, EM, Rousseau, H, Kaskarelis, I, Riambau, V, Coppi, G, Ferro, C, Sassi, C, Esteban, C, Mangialardi, N, Tealdi, DG, Nano, G, Schoder, M, Funovics, M, Buz, S & Hetzer, R 2014, 'Endovascular repair of traumatic thoracic aortic injury: Final results from the relay endovascular registry for thoracic disease', Annals of Thoracic Surgery, vol. 97, no. 3, pp. 774-780. https://doi.org/10.1016/j.athoracsur.2013.09.034
Zipfel, Burkhart ; Chiesa, Roberto ; Kahlberg, Andrea ; Marone, Enrico Maria ; Rousseau, Herve ; Kaskarelis, Ioannis ; Riambau, Vincent ; Coppi, Gioacchino ; Ferro, Carlo ; Sassi, Carlo ; Esteban, Carlos ; Mangialardi, Nicola ; Tealdi, Domenico G. ; Nano, Giovanni ; Schoder, Maria ; Funovics, Martin ; Buz, Semih ; Hetzer, Roland. / Endovascular repair of traumatic thoracic aortic injury : Final results from the relay endovascular registry for thoracic disease. In: Annals of Thoracic Surgery. 2014 ; Vol. 97, No. 3. pp. 774-780.
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abstract = "Background In blunt thoracic aortic injury, thoracic endovascular aortic repair (TEVAR) offers a less invasive alternative to open chest surgery. New reliable and accurate stent grafts have widened the endovascular treatment options. We report our experience with the Relay stent graft Bolton Medical, Sunrise, FL; Barcelona, Spain) for treatment of this injury. Methods Relay Endovascular Registry for Thoracic Disease (RESTORE) is a multicenter, prospective European registry, which enrolled patients treated with the Relay stent graft for thoracic aortic diseases from April 2005 to January 2009. Regular follow-up examinations were conducted for up to 24 months. This paper analyzes the cohort of patients treated for traumatic aortic injury. Results Forty adult trauma patients from 12 European centers underwent TEVAR. Mean age was 40 years and 34 patients were male. The proximal landing zone involved aortic arch zones 1 to 2 in 40{\%} and zone 3 in 55{\%} of procedures. Technical success was achieved in all cases. One (2.5{\%}) patient suffered a rupture of the iliac artery. No patient developed procedure-related paraplegia or required conversion to open surgery. Follow-up imaging demonstrated complete exclusion of the traumatic tear and regression of the false aneurysms without endoleak or graft infolding. One late device-related complication was reported; penetration of the distal end of the stent graft treated by stent-graft extension. Thirty-day mortality was 2.5 {\%} (n = 1), and late mortality 2.5{\%} due to a secondary accident. Actuarial 2-year survival was 93.7{\%}. Conclusions Thoracic endovascular aortic repair with the Relay stent graft is a safe and effective treatment for patients with traumatic aortic injury.",
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AU - Zipfel, Burkhart

AU - Chiesa, Roberto

AU - Kahlberg, Andrea

AU - Marone, Enrico Maria

AU - Rousseau, Herve

AU - Kaskarelis, Ioannis

AU - Riambau, Vincent

AU - Coppi, Gioacchino

AU - Ferro, Carlo

AU - Sassi, Carlo

AU - Esteban, Carlos

AU - Mangialardi, Nicola

AU - Tealdi, Domenico G.

AU - Nano, Giovanni

AU - Schoder, Maria

AU - Funovics, Martin

AU - Buz, Semih

AU - Hetzer, Roland

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N2 - Background In blunt thoracic aortic injury, thoracic endovascular aortic repair (TEVAR) offers a less invasive alternative to open chest surgery. New reliable and accurate stent grafts have widened the endovascular treatment options. We report our experience with the Relay stent graft Bolton Medical, Sunrise, FL; Barcelona, Spain) for treatment of this injury. Methods Relay Endovascular Registry for Thoracic Disease (RESTORE) is a multicenter, prospective European registry, which enrolled patients treated with the Relay stent graft for thoracic aortic diseases from April 2005 to January 2009. Regular follow-up examinations were conducted for up to 24 months. This paper analyzes the cohort of patients treated for traumatic aortic injury. Results Forty adult trauma patients from 12 European centers underwent TEVAR. Mean age was 40 years and 34 patients were male. The proximal landing zone involved aortic arch zones 1 to 2 in 40% and zone 3 in 55% of procedures. Technical success was achieved in all cases. One (2.5%) patient suffered a rupture of the iliac artery. No patient developed procedure-related paraplegia or required conversion to open surgery. Follow-up imaging demonstrated complete exclusion of the traumatic tear and regression of the false aneurysms without endoleak or graft infolding. One late device-related complication was reported; penetration of the distal end of the stent graft treated by stent-graft extension. Thirty-day mortality was 2.5 % (n = 1), and late mortality 2.5% due to a secondary accident. Actuarial 2-year survival was 93.7%. Conclusions Thoracic endovascular aortic repair with the Relay stent graft is a safe and effective treatment for patients with traumatic aortic injury.

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