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Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review
Background: Blunt and penetrating traumatic thoracic aortic injuries constitute surgical emergencies that are attended with high mortality rates. Most patients do not survive long enough, post injury, to reach a hospital. On-site mortality rates may approach approximately 85%. Two main treatment opt...
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| Format: | Thesis |
| Language: | English |
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Division of General Surgery
2019
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| _version_ | 1867613181704142848 |
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| access_status_str | Open Access |
| author | Chinyepi, Nkhabe |
| author2 | Naidoo, Nadraj G |
| author_browse | Chinyepi, Nkhabe Naidoo, Nadraj G |
| author_facet | Naidoo, Nadraj G Chinyepi, Nkhabe |
| author_sort | Chinyepi, Nkhabe |
| collection | Thesis |
| description | Background: Blunt and penetrating traumatic thoracic aortic injuries constitute surgical emergencies that are attended with high mortality rates. Most patients do not survive long enough, post injury, to reach a hospital. On-site mortality rates may approach approximately 85%. Two main treatment options for blunt thoracic aortic injuries (BTAI) are open surgery and thoracic endovascular repair (TEVAR). Penetrating thoracic aortic injuries (PTAI) have a higher mortality than blunt trauma, with patients often only reaching the hospital in extremis. Most will require early intervention. Currently TEVAR is rapidly evolving as the standard of care for thoracic aortic injuries (TAI) at many centres, primarily due to the emerging evidence of lower mortality and morbidity trends in comparison to open surgery (1–4).
Methods: From December 2006 to December 2016, 34 patients (30 blunt trauma, 4 penetrating trauma) with traumatic aortic injuries (grades I-IV) were treated with thoracic aortic stent-grafts in the Groote Schuur Hospital Vascular Unit, Cape Town. We assessed the technical and clinical outcomes following TEVAR in these patients.
Results: The 30- day mortality rate was 5.8%, corresponding to 2 deaths both associated with the index trauma-related fatal strokes. The overall mortality rate was 11.8% (4/34): three deaths were due to major strokes and one death was related to pulmonary complications.
Conclusion: TEVAR after TAI is associated with significantly lower procedural and postoperative mortality. The 30 day and overall mortality after TEVAR in our unit is comparable to international standards. Even though there is a paucity of literature on PTAI, TEVAR has low peri-procedural adverse events and is safe in selected patients. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/29270 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:03.909Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/29270 Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review Chinyepi, Nkhabe Naidoo, Nadraj G General Surgery Background: Blunt and penetrating traumatic thoracic aortic injuries constitute surgical emergencies that are attended with high mortality rates. Most patients do not survive long enough, post injury, to reach a hospital. On-site mortality rates may approach approximately 85%. Two main treatment options for blunt thoracic aortic injuries (BTAI) are open surgery and thoracic endovascular repair (TEVAR). Penetrating thoracic aortic injuries (PTAI) have a higher mortality than blunt trauma, with patients often only reaching the hospital in extremis. Most will require early intervention. Currently TEVAR is rapidly evolving as the standard of care for thoracic aortic injuries (TAI) at many centres, primarily due to the emerging evidence of lower mortality and morbidity trends in comparison to open surgery (1–4). Methods: From December 2006 to December 2016, 34 patients (30 blunt trauma, 4 penetrating trauma) with traumatic aortic injuries (grades I-IV) were treated with thoracic aortic stent-grafts in the Groote Schuur Hospital Vascular Unit, Cape Town. We assessed the technical and clinical outcomes following TEVAR in these patients. Results: The 30- day mortality rate was 5.8%, corresponding to 2 deaths both associated with the index trauma-related fatal strokes. The overall mortality rate was 11.8% (4/34): three deaths were due to major strokes and one death was related to pulmonary complications. Conclusion: TEVAR after TAI is associated with significantly lower procedural and postoperative mortality. The 30 day and overall mortality after TEVAR in our unit is comparable to international standards. Even though there is a paucity of literature on PTAI, TEVAR has low peri-procedural adverse events and is safe in selected patients. 2019-02-04T12:52:24Z 2019-02-04T12:52:24Z 2018 2019-02-01T08:35:29Z Master Thesis Masters MMed http://hdl.handle.net/11427/29270 eng application/pdf Division of General Surgery Faculty of Health Sciences University of Cape Town |
| spellingShingle | General Surgery Chinyepi, Nkhabe Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review |
| thesis_degree_str | Master's |
| title | Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review |
| title_full | Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review |
| title_fullStr | Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review |
| title_full_unstemmed | Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review |
| title_short | Outcomes after thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injuries (TTAI) - a single center retrospective review |
| title_sort | outcomes after thoracic endovascular aortic repair tevar in patients with traumatic thoracic aortic injuries ttai a single center retrospective review |
| topic | General Surgery |
| url | http://hdl.handle.net/11427/29270 |
| work_keys_str_mv | AT chinyepinkhabe outcomesafterthoracicendovascularaorticrepairtevarinpatientswithtraumaticthoracicaorticinjuriesttaiasinglecenterretrospectivereview |