Factors affecting success in endovascular treatment of acute aortic transections

Özlem Balcıoğlu, S. Karaca, M. Parildar, Ümit Kahraman, H. Posacioglu
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Abstract

Aim: In this study, it was aimed to present the results of patients treated with endovascular treatment between 2002 and 2018 with the diagnosis of Acute Aortic Transection and the factors that may affect the success. Materials and Methods: A total of 17 patients were included in the study and it was planned as retrospectively. All data of the patients were collected by file searching method and demographic features of the patients were recorded. Written informed consent was obtained from all patients prior to study. Trauma types and gender ratios of the patients were calculated as percentages.. Contrast-enhanced thoraco-abdominal computed tomography was performed for definitive diagnosis, and endovascular treatment was evaluated. All patients deemed suitable for endovascular treatment were intervened within the first 24 hours. Results: The most majority of our patient group was in stage 4 and the most common etiology was recorded as in - vehicle traffic accidents. Of the 17 patients included in the study, 2 died in the early period and 1 died in the follow-up period. Complications such as graft migration, pseudo aneurysm and graft kinking, which are known as complications of endovascular treatment, were not encountered. Although the left subclavian artery was closed in 12 of 17 patients, only two of them required carotid-subclavian bypass. Conclusion: The fact that endovascular treatment can be applied with low mortality compared to conventional surgery reduces mortality in acute aortic transections. The most important factors affecting the success of the treatment are that the intervention is performed in the 24 hours, in experienced centers, and that 10% of the aortic diameter is not exceeded in the graft selection, and balloon dilatation is avoided.
影响急性主动脉切断术血管内治疗成功的因素
目的:本研究旨在介绍2002年至2018年诊断为急性主动脉横断的患者接受血管内治疗的结果及可能影响成功的因素。材料与方法:本研究共纳入17例患者,采用回顾性研究。采用档案检索法收集患者资料,并记录患者的人口学特征。在研究前获得了所有患者的书面知情同意。创伤类型和患者性别比例以百分比计算。进行增强胸腹计算机断层扫描以明确诊断,并评估血管内治疗。所有认为适合血管内治疗的患者均在最初24小时内进行干预。结果:本组患者绝大多数为第4期,最常见的病因为交通事故。纳入研究的17例患者中,2例早期死亡,1例随访死亡。并发症如移植物迁移,假性动脉瘤和移植物扭结,这些被称为血管内治疗的并发症,没有遇到。虽然17例患者中有12例左侧锁骨下动脉关闭,但只有2例需要颈动脉-锁骨下搭桥。结论:与常规手术相比,血管内治疗可降低急性主动脉切断术的死亡率。影响治疗成功的最重要因素是在24小时内,在经验丰富的中心进行干预,在选择移植物时不超过主动脉直径的10%,避免球囊扩张。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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