초록접수 현황
| 17F-035 | 구연 미채택시 포럼 발표 |
Isthmus Aortic Narrowing after Thoracic Endovascular Aortic Repair(TEVAR)in Traumatic Aortic Transection
Joung Taek Kim, Wan Ki Baek, Yong Han Yoon, Young Sam Kim, Ji Hae kim, Yong Zik Lee, Jeong Im Cho, Ju Hyun Sung, Chang Wan So
Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
Purpose : TEVAR technique appears a good alternative for treating acute traumatic transection of the thoracic aorta (TTA). Transection point is located in aortic isthmus, where the angle is curved. Furthermore, most patients with aortic transection have normal sized aorta diameter. We evaluated the presence of isthmus stenosis in patients who underwent TEVAR for aortic injury.
Methods : The records of 18 patients that underwent TEVAR for TTA were divided two groups as aortic narrowing group (AN) and non aortic narrowing group(NAN). AN was defined as stent graft folding at aortic isthmus confirmed by 3D CT. The length of aorta at isthmus, sagittal and coronal view, pseudoaneurysm, from left subclavian artery to transection, and angle of isthmus were measured using 3D CT. Mann-Whitney test was used for statistical analysis.
Results : Aortic narrowing was noted in 5 patients(31%). Among them blood pressure difference was noted in two patients (each 20 and 10 mmHg at systole). Area index in NAN (2.16±0.36 cm2/M2) was larger than AN (1.74±0.84 cm2/M2).Size of pseudoaneurysm in NAN (31.9±4.3 mm) was smaller than AN (37.4±7.5 mm).Length from subclavian artery in NAN (15.7±9.4 mm) was longer than AN (8.4±3.2 mm), but not statistically significant. Angle of isthmus in NAN(131±6°) was larger than AN(105±2.7°), and it was only statistically significant (p=0.002). Stent size, diameter of aorta, injury severity score, and age were not statistically significant.
Conclusion : Isthmus aortic narrowing by stent graft folding should be considered when performing TEVAR in traumatic aortic transection with acute angle of isthmus less than 110 degree.
Methods : The records of 18 patients that underwent TEVAR for TTA were divided two groups as aortic narrowing group (AN) and non aortic narrowing group(NAN). AN was defined as stent graft folding at aortic isthmus confirmed by 3D CT. The length of aorta at isthmus, sagittal and coronal view, pseudoaneurysm, from left subclavian artery to transection, and angle of isthmus were measured using 3D CT. Mann-Whitney test was used for statistical analysis.
Results : Aortic narrowing was noted in 5 patients(31%). Among them blood pressure difference was noted in two patients (each 20 and 10 mmHg at systole). Area index in NAN (2.16±0.36 cm2/M2) was larger than AN (1.74±0.84 cm2/M2).Size of pseudoaneurysm in NAN (31.9±4.3 mm) was smaller than AN (37.4±7.5 mm).Length from subclavian artery in NAN (15.7±9.4 mm) was longer than AN (8.4±3.2 mm), but not statistically significant. Angle of isthmus in NAN(131±6°) was larger than AN(105±2.7°), and it was only statistically significant (p=0.002). Stent size, diameter of aorta, injury severity score, and age were not statistically significant.
Conclusion : Isthmus aortic narrowing by stent graft folding should be considered when performing TEVAR in traumatic aortic transection with acute angle of isthmus less than 110 degree.
첨부파일 : Fig.docx
책임저자: Joung Taek Kim
Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
발표자: Joung Taek Kim, E-mail : jtkim@inha.ac.kr