Data were collected prospectively and analyzed retrospectively. We assessed the difference between
the largest diameter of the aneurysm (D) and the diameter of the stent-graft body (DI) on each postoperative CT scan. SSR was defined as a minimum of 75% reduction of this see more difference between the first and any of the following CT scans. Treatment success was defined as survival free of aneurysm-related death, type I or III endoleak, aneurysm expansion exceeding 5 mm, rupture, surgical conversion, migration, and graft occlusion. To assess the predictive factors of SSR, we performed a multivariable analysis and a logistic regression of the most significant variables.
Results: SSR was observed in 24.8% (92/371) of the patients after an average of 26 +/- 21 months of FU. The mean duration of FU in this group was 50 +/- 26 months (vs 45 +/- 25 months; P = NS). Survival was significantly longer in the SSR group (96 +/- 3 months vs 93 +/- 3 months; P < .05). No rupture, surgical, or endovascular conversion Citarinostat research buy was reported in the SSR group. The frequency of type I (2.2% vs 15.4%; P < .001), type II (3.3% vs 29.4%; P < 10(-6)), and secondary interventions (3.3% vs 13.3%;P < .05) was lower in the SSR group. All type I and III endoleaks were diagnosed and treated before SSR detection. Since SSR was detected, treatment
success remained until last follow-up in 98.9% (91 of 92) of the patients. The independent predictive factors of SSR were abdominal aortic aneurysm (AAA) diameter <55 mm (odds ratio [OR] 3.91; 95% confidence interval [CI]: 2.16-7.11), infra renal aorta diameter <23 mm (OR 2.96; 95% CI: 1.74-5.03), and a proximal neck length >22 mm (OR 2.41; 95% CI: 1.42-4.10).
Conclusion: In this series, SSR was accurately predictive of a durable success after EVAR.
It occurred mostly in patients with a favorable anatomy. Less intensive follow-up work up seems to be safe in patients with SSR. (J Vase Surg 2010; 52:878-83.)”
“Introduction: Traumatic aortic injury (TAI) is a rare yet highly lethal injury associated with blunt force deceleration injury. The adoption of thoracic endovascular aortic repair (TEVAR) has become a safer option than traditional Ribonucleotide reductase open repair. The purpose of this study is to review a rural trauma center experience with TAI.
Methods: A retrospective analysis was performed, reviewing all patients who presented with TAI between 2000 and 2009. Clinical, anatomical, and procedural variables of all cases were systematically reviewed. Clinical endpoints included mortality, and aortic-related mortality, and hospital length of stay. The study population was stratified by those that underwent surgical repair (SR) and those managed medically (MM).
Results: Fifty-six patients presented with blunt TAT; 35 patients (62.5%) were surgically repaired (22 open, 13 TEVAR), while 21 (37.5%) were MM. The only difference in comorbidities was a higher rate of coronary artery disease in MM.