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IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203112
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Open Access Original Research
Endovascular repair of traumatic aortic dissection: a single-center experience
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1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
2 Hubei Key Laboratory of Molecular Imaging, 430022 Wuhan, Hubei, China
These authors contributed equally.
Rev. Cardiovasc. Med. 2021, 22(3), 1029–1035; https://doi.org/10.31083/j.rcm2203112
Submitted: 19 June 2021 | Revised: 16 August 2021 | Accepted: 17 August 2021 | Published: 24 September 2021
(This article belongs to the Special Issue State-of-the-Art Cardiovascular Medicine in Asia 2021)
Abstract

The data on endovascular aortic repair (EVAR) for traumatic aortic dissection (TAD) are lacking. Hence, this study aimed to evaluate the efficacy of EVAR for TAD and report our experience based on patients from our medical center with a relatively long follow-up. A total of 25 consecutive patients with TAD underwent EVAR from October 2015 to October 2020. The demographics, imaging characteristics, clinical features, treatment details, and follow-up results were reviewed. Urgent EVAR was performed in 3 patients (12%), while the remaining 22 patients (88%) underwent delayed EVAR. Systematic heparinization was used in all patients during the endovascular procedure. The EVAR was technically successful in all patients, with no cases converted into open surgery. No death occurred during the perioperative period. One patient presented with a type II endoleak on postoperative 1-month CT images during a mean follow-up of 42.3 $\pm$ 17.7 months (5–67.5 months) and showed spontaneous regression of the endoleak without any intervention during the subsequent follow-up. All the patients survived until the time of writing, and none of them showed late endoleak, stent migration, paraplegia, and reintervention. The patients with left subclavian artery covered (n = 8) had no obvious ischemia of the arm and brain. The study results demonstrated that EVAR for TAD proved to be safe and effective, and most patients could undergo delayed EVAR. Systematically heparinization during EVAR under the setting of multi-trauma was safe.

Keywords
Aortic dissection
Endovascular aortic repair
Stent
Trauma
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