TY - JOUR
T1 - Thoracic endovascular aortic repair for traumatic aortic injuries
T2 - insight from literature and practical recommendations
AU - Dalessio, Ilenia
AU - doManin, Maurizio
AU - Bissacco, Daniele
AU - Rimoldi, Pierantonio
AU - Palmieri, Bruno
AU - Piffaretti, Gabriele
AU - Trimarchi, Santi
N1 - Publisher Copyright:
© 2020 ediZioNi MiNerVa MediCa.
PY - 2020/12
Y1 - 2020/12
N2 - iNTroduCTioN: Thoracic endovascular aortic repair (TeVar) for treatment of blunt traumatic aortic injuries (BTais) is nowadays the gold standard technique in adult patients, replacing gradually the use of open repair (or). although randomized controlled trials will never be performed comparing TeVar to or for BTais management, trauma and vascular societies guidelines today primarily recommend the former for BTai patients with a suitable anatomy. The aim of this review was to describe past and recent data published in literature regarding pros and cons of TeVar treatment in BTai, and to analyze some debated issues and future perspectives. eVideNCe aCQuisiTioN: Preferred reporting items for systematic reviews and Meta-analyses (PrisMa) guidelines and scale for the assessment of Narrative review articles (saNra) were used to obtain and describe selected articles on TeVar in BTai. eVideNCe syNThesis: young (<50 years) men were the most operated population. The use of TeVar increased over the years, with a progressive reduction in mortality and overall postoperative complication rates when compared with or. lack of information remains about the percentage of urgent cases. CoNClusioNs: TeVar is considered nowadays the treatment of choice in BTai patients. in case of aortic rupture (grade iV) the treatment is mandatory, while intimal tear (grade i) and intramural hematoma (grade ii) can be safely managed with no operative management (NoM). Debate is still ongoing on grade III (pseudoaneurysms). Unfortunately, several aspects remain not yet clarified, including disease classification, type and grade to treat, timing (urgent versus elective), priority of vascular injuries in polytrauma patients, and TeVar use in pediatrics and young patients.
AB - iNTroduCTioN: Thoracic endovascular aortic repair (TeVar) for treatment of blunt traumatic aortic injuries (BTais) is nowadays the gold standard technique in adult patients, replacing gradually the use of open repair (or). although randomized controlled trials will never be performed comparing TeVar to or for BTais management, trauma and vascular societies guidelines today primarily recommend the former for BTai patients with a suitable anatomy. The aim of this review was to describe past and recent data published in literature regarding pros and cons of TeVar treatment in BTai, and to analyze some debated issues and future perspectives. eVideNCe aCQuisiTioN: Preferred reporting items for systematic reviews and Meta-analyses (PrisMa) guidelines and scale for the assessment of Narrative review articles (saNra) were used to obtain and describe selected articles on TeVar in BTai. eVideNCe syNThesis: young (<50 years) men were the most operated population. The use of TeVar increased over the years, with a progressive reduction in mortality and overall postoperative complication rates when compared with or. lack of information remains about the percentage of urgent cases. CoNClusioNs: TeVar is considered nowadays the treatment of choice in BTai patients. in case of aortic rupture (grade iV) the treatment is mandatory, while intimal tear (grade i) and intramural hematoma (grade ii) can be safely managed with no operative management (NoM). Debate is still ongoing on grade III (pseudoaneurysms). Unfortunately, several aspects remain not yet clarified, including disease classification, type and grade to treat, timing (urgent versus elective), priority of vascular injuries in polytrauma patients, and TeVar use in pediatrics and young patients.
KW - Aorta
KW - Systematic review
KW - Wounds and injuries
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U2 - 10.23736/S0021-9509.20.11580-5
DO - 10.23736/S0021-9509.20.11580-5
M3 - Review article
C2 - 32964899
AN - SCOPUS:85097908402
VL - 61
SP - 681
EP - 696
JO - Journal of Cardiovascular Surgery
JF - Journal of Cardiovascular Surgery
SN - 0021-9509
IS - 6
ER -