Minimally invasive repair of an aortic tear may have a higher survival rate than traditional open surgery
Minimally invasive repair of an aortic tear may have
a higher survival rate than traditional open surgery, according to a presentation
at the nineteenth International Symposium on Endovascular Therapy.
Injury to the aorta is the second most common cause of
death from a motor vehicle accident or fall. Of every 10 people who have this
type of injury, 9 bleed to death at the accident scene. Many of those who reach
the hospital die because open-chest surgery is too risky when compounded by other
serious injuries. Minimally invasive repair of the tear with an endograft, a fabric
tube supported by a stent, is less risky because it can be done without opening
the chest.
In the study, 100 percent of trauma patients who underwent
minimally invasive endograft repair survived, whereas 31 percent of patients who
had open-chest surgical repair died.
"Many of these typically young and otherwise healthy
people die of aorta injuries after reaching the hospital because their bodies
haven't stabilized enough to undergo surgery," said Oren Steinmetz, MD, associate
professor, McGill University Health Center, in Montreal. "Placing an endograft
allows us to correct a life-threatening problem sooner and in a far less invasive
and less dangerous way. Then we can also more easily treat the other injuries."
The study included 28 patients diagnosed with blunt thoracic
aortic injury who were treated at McGill University Health Center; 16 were treated
with open surgery and 12 were treated with minimally invasive endograft repair.
In the surgical group, 5 patients died (31 percent), one suffered paraplegia (6
percent) and one underwent repeat surgery for excessive bleeding (6 percent).
In the endograft group, no patients died, suffered paraplegia or had to undergo
a second procedure.
"Our early study suggests that endograft repair
is likely to be more successful than surgery in these patients," said Steinmetz.
"At our institution, all patients with this type of injury are now offered
this alternative to surgery whenever possible."
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