Efficacy and Safety of Heparinization before Deployment of Endograft for Blunt Traumatic Aortic Injury in Severely Injured Patients
dc.creator | Makaloski V., Widenka H., Schönhoff F., Spanos K., Wyss T.R., Schmidli J. | en |
dc.date.accessioned | 2023-01-31T08:55:55Z | |
dc.date.available | 2023-01-31T08:55:55Z | |
dc.date.issued | 2021 | |
dc.identifier | 10.1016/j.avsg.2021.01.096 | |
dc.identifier.issn | 08905096 | |
dc.identifier.uri | http://hdl.handle.net/11615/76121 | |
dc.description.abstract | Background: The administration of unfractionated heparin (UFH) during endovascular repair of blunt traumatic aortic injury (BTAI) is controversial. The aim of the study is to report the early outcomes of patients undergoing thoracic endovascular aortic repair (TEVAR) for BTAI, and to assess the individualized intraoperative use and dose of UFH. Methods: This is a retrospective analysis including consecutive patients treated with TEVAR for BTAI of the descending aorta between January 1st, 2005 and December 31st, 2018. Intraoperative use and doses of UFH were analyzed. Primary outcome included a reintervention because of new onset bleeding and/or thromboembolic complication and 30-day mortality. Technical success, injury severity score (ISS), timing of treatment, and neurologic deterioration were secondary outcome. Results: Thirty-six patients with a mean age of 47 ± 18 years, 30 males (83%), were included. Intraoperative administration of UFH was recorded in 30/36 patients (83%) with a mean dose of 4750 ± 2180 IU. Two patients had no UFH because of extensive intracranial hemorrhage or suspected relevant liver laceration, respectively; 1 died in theatre, 1 was already anticoagulated having a mechanical aortic valve, and in 2 no information about heparin use was found. During 30 days of follow-up, 3 patients died (8%; 3/36): 1 patient with completely transected aorta died on-table and 2 on the fifth postoperative day, 1 from trauma-associated brain injury and 1 with multi organ failure. No bleeding or thromboembolic complication requiring reintervention occurred in any patient during 30 days follow-up. In 3 patients partial unintentional coverage of the left common carotid artery occurred, resulting in technical success of 89% (32/36). Mean ISS was 43 ± 15. Thirty-five patients (97%) were severely injured having an ISS ≥ 25. Twenty-nine patients (81%) were treated within 24 hr and 6 patients (17%) within 1 week. No stroke or spinal cord ischemia was observed. Conclusions: Systemic heparinization in different doses during TEVAR for BTAI can be safe with no intraoperative bleeding or thromboembolic complications in early postoperative period. © 2021 | en |
dc.language.iso | en | en |
dc.source | Annals of Vascular Surgery | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85101528500&doi=10.1016%2fj.avsg.2021.01.096&partnerID=40&md5=b09e0189794b23b2104d2c5a4fa9a1ff | |
dc.subject | heparin | en |
dc.subject | iodinated contrast medium | en |
dc.subject | warfarin | en |
dc.subject | anticoagulant agent | en |
dc.subject | heparin | en |
dc.subject | adolescent | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | anticoagulant therapy | en |
dc.subject | aortic graft | en |
dc.subject | aortic trauma | en |
dc.subject | Article | en |
dc.subject | brain hematoma | en |
dc.subject | brain hemorrhage | en |
dc.subject | brain injury | en |
dc.subject | clinical article | en |
dc.subject | computed tomographic angiography | en |
dc.subject | coronary artery bypass graft | en |
dc.subject | descending aorta | en |
dc.subject | drug efficacy | en |
dc.subject | drug safety | en |
dc.subject | endovascular aneurysm repair | en |
dc.subject | epidural hematoma | en |
dc.subject | face injury | en |
dc.subject | falling | en |
dc.subject | female | en |
dc.subject | fluoroscopy | en |
dc.subject | follow up | en |
dc.subject | head and neck injury | en |
dc.subject | hematothorax | en |
dc.subject | hemorrhagic shock | en |
dc.subject | heparinization | en |
dc.subject | human | en |
dc.subject | injury scale | en |
dc.subject | injury severity | en |
dc.subject | international standard unit | en |
dc.subject | laceration | en |
dc.subject | left common carotid artery | en |
dc.subject | left subclavian artery | en |
dc.subject | limb fracture | en |
dc.subject | liver injury | en |
dc.subject | lung injury | en |
dc.subject | male | en |
dc.subject | middle aged | en |
dc.subject | mortality rate | en |
dc.subject | multiple organ failure | en |
dc.subject | operation duration | en |
dc.subject | osteosynthesis | en |
dc.subject | pelvis fracture | en |
dc.subject | postoperative period | en |
dc.subject | preoperative evaluation | en |
dc.subject | retrospective study | en |
dc.subject | revascularization | en |
dc.subject | rib fracture | en |
dc.subject | skiing | en |
dc.subject | spine fracture | en |
dc.subject | spine surgery | en |
dc.subject | spleen injury | en |
dc.subject | sport injury | en |
dc.subject | subdural hematoma | en |
dc.subject | suicide | en |
dc.subject | surgical mortality | en |
dc.subject | thoracotomy | en |
dc.subject | thorax drainage | en |
dc.subject | thromboembolism | en |
dc.subject | traffic accident | en |
dc.subject | young adult | en |
dc.subject | adverse event | en |
dc.subject | aorta | en |
dc.subject | blood vessel injury | en |
dc.subject | blood vessel prosthesis | en |
dc.subject | blood vessel transplantation | en |
dc.subject | blunt trauma | en |
dc.subject | devices | en |
dc.subject | diagnostic imaging | en |
dc.subject | drug administration | en |
dc.subject | endovascular surgery | en |
dc.subject | injury | en |
dc.subject | operative blood loss | en |
dc.subject | risk assessment | en |
dc.subject | risk factor | en |
dc.subject | thromboembolism | en |
dc.subject | time factor | en |
dc.subject | treatment outcome | en |
dc.subject | Adult | en |
dc.subject | Aged | en |
dc.subject | Anticoagulants | en |
dc.subject | Aorta | en |
dc.subject | Blood Loss, Surgical | en |
dc.subject | Blood Vessel Prosthesis | en |
dc.subject | Blood Vessel Prosthesis Implantation | en |
dc.subject | Drug Administration Schedule | en |
dc.subject | Endovascular Procedures | en |
dc.subject | Female | en |
dc.subject | Heparin | en |
dc.subject | Humans | en |
dc.subject | Injury Severity Score | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Retrospective Studies | en |
dc.subject | Risk Assessment | en |
dc.subject | Risk Factors | en |
dc.subject | Thromboembolism | en |
dc.subject | Time Factors | en |
dc.subject | Treatment Outcome | en |
dc.subject | Vascular System Injuries | en |
dc.subject | Wounds, Nonpenetrating | en |
dc.subject | Elsevier Inc. | en |
dc.title | Efficacy and Safety of Heparinization before Deployment of Endograft for Blunt Traumatic Aortic Injury in Severely Injured Patients | en |
dc.type | journalArticle | en |
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