Abstract text (incl. references and figure legends)
Introduction
Traumatic thoracic aortic injury is the second leading cause of mortality among patients with multiple trauma. Recently, thoracic endovascular aortic repair (TEVAR) has been used as a treatment option. In trauma patients, it may be challenging to repair immediately if hemodynamically unstable. Therefore, we aim to investigate the outcomes of patients who underwent immediate and delayed TEVAR.
Material & Methods
Among the patients who visited the trauma center from January 2012 to July 2022, we retrospectively analyzed the medical records of patients who underwent TEVAR. We divided patients into a group with time from admission to procedure within 24 hours and a group after 24 hours. And complications such as in-hospital and endoleak were identified.
Results
From January 2012 to July 2022, a total of 31 patients out of 83 patients who visited the trauma center for traumatic thoracic aortic injury underwent TEVAR (80.6% males, mean age 58 years). The average ISS was 37.69. Among them, 18 were in the group within 24 hours of admission to the procedure, and 13 were in the group after 24 hours. There were no statistical differences in initial vital signs, Glasgow Coma Scale score, injury severity score, and aortic injury grades between the two groups. There was a significant difference in vasoactive inotropic score (VIS) in the group within 24 hours (9.33) and in the group after 24 hours (26.02) (p=0.068). Two deaths and 3 patients with endoleak were confirmed only in the within 24 hours group.
Conclusions
Even if TEVAR is performed after resuscitation in multiple trauma patients with high VIS, the incidence of complications, such as death or endoleak does not increase.
References
Marcaccio CL, Dumas RP, Huang Y, Yang W, Wang GJ, Holena DN. Delayed endovascular aortic repair is associated with reduced in-hospital mortality in patients with blunt thoracic aortic injury. Journal of vascular surgery. 2018;68(1):64-73.
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