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2. Thoracic Vascular Trauma

Author

Albini, Paul T., Brenner, Megan L., Coimbra, Raul, Coccolini, Federico, Series Editor, Coimbra, Raul, Series Editor, Kirkpatrick, Andrew W., Series Editor, Di Saverio, Salomone, Series Editor, Ansaloni, Luca, Editorial Board Member, Balogh, Zsolt, Editorial Board Member, Biffl, Walt, Editorial Board Member, Catena, Fausto, Editorial Board Member, Davis, Kimberly, Editorial Board Member, Ferrada, Paula, Editorial Board Member, Fraga, Gustavo, Editorial Board Member, Ivatury, Rao, Editorial Board Member, Kluger, Yoram, Editorial Board Member, Leppaniemi, Ari, Editorial Board Member, Maier, Ron, Editorial Board Member, Moore, Ernest E., Editorial Board Member, Napolitano, Lena, Editorial Board Member, Peitzman, Andrew, Editorial Board Member, Reilly, Patrick, Editorial Board Member, Rizoli, Sandro, Editorial Board Member, Sakakushev, Boris, Editorial Board Member, Sartelli, Massimo, Editorial Board Member, Scalea, Thomas, Editorial Board Member, Spain, David, Editorial Board Member, Stahel, Philip, Editorial Board Member, Sugrue, Michael, Editorial Board Member, Velmahos, George, Editorial Board Member, Weber, Dieter, Editorial Board Member, and Galante, Joseph M., editor

Published
2021
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13. Surveillance Strategies and Long-Term Scoping Review of Outcomes After Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Author

Le, John Bao Phuc, Hussain, Ali, DuBose, Joseph, Roberts, Derek, Brenner, Megan L, Horer, Tal, Cagiannos, Catherine, Eimaan Khan, Dubois, Luc, Shorr, Risa, Nagpal, Sudhir, Jetty, Prasad, and Vincent, Remi

Subjects
Traumatic, Medtronic, Epidemiology, aortic arch, Thoracic, Medical Physiology, adverse event, FOS: Basic medicine, abdominal aorta, Injury, migration, patients, vascular surgery, adjunctive procedure, clinical, adjunctive, Medtronic Valiant, wound complication, stentgraft, stent fracture, stent induced new entry, freedom from mortality, thoracic aorta, left ventricular stiffening, LSA, dynes, follow-up, Medtronic Talent, RGAD, angiography, TEVAR, extension, aortobronchial fistula, gore, endograft, malapposition, Zenith, congestive heart failure, collapse, percutaneous, quality, Re-TEVAR, MVC, reinterventions, surveillance, access complication, Public Health, carotid-subclavian transposition, explantation, relining, zone 1 debranching, attrition, Gore TAG, computed tomography with contrast, endpoints, fall, carotid-subclavian bypass, non-invasive, technical success, wire, endoleak, Trauma, blunt, Cook Tx2, surveillance regimen, surgical, time intervals, aortoesophageal fistula, death, interventional radiology, case report, maldeployment, sentinel events, left subclavian artery revascularization, exclusion, infolding, secondary endpoints, loss to follow-up, CTA, evidence, young, Aortic, vascular access, adverse, pseudoaneurysm, computed tomography, prospective, mortality, radiology, SINE, open repair, young patients, pivotal trials, intraoperative conversion, Gore cTAG, Zenith Alpha, left ventricular remodelling, graft, Surgery, scoping review, Physiological Processes, aortic-related mortality, antegrade, Medical Sciences, reporting standards, data analysis, surveillance regimens, morbidity, retrograde, Analytical, Diagnostic and Therapeutic Techniques and Equipment, freedom from reintervention, Cardiovascular System, systematic review, vascular, fabric fatigue, Medical Specialties, Medicine and Health Sciences, magnetic resonance imaging, aortotracheal fistula, remodelling, EVAR, left subclavian artery, windkessel effect, thoracic endograft, loss to follow up, Aorta, proximal extension, bird-beaking, case series, stent-graft induced new entry, stroke, left ventricular hypertrophy, thoracic graft, MRA, endovascular, quadriplegia, revascularization, Anatomy, PTFE, FDA, MRI, distal extension, CT, open conversion, Critical Care, conflict of interest, cardiac, Other Medical Specialties, retrospective, LSAC, stenting, cerebrospinal fluid drainage, paralysis, thoracic endovascular aortic repair, paraplegia, paresis, cancer, follow up, stochastic, conversion, multi-organ failure, magnetic resonance angiography, in situ reconstruction, fabric tear, left subclavian artery coverage, adverse events, spinal cord injury, radiation, meta-analysis, nitinol, BTAI, retrograde aortic dissection, explant and extra-anatomic bypass, car crash, TAG, rupture, surgeon, stent, motor vehicle collision, Bolton Relay Pro, FDA-approved, neoplasm, malignancy
Abstract

A Scoping Review that aims to map the following objectives regarding Blunt Thoracic Aortic Injury (BTAI) patients treated with Thoracic Endovascular Repair (TEVAR) via appraisal of all forms of original literature published ≥2005: reporting details & rationale of surveillance strategies, along with congruence versus deviance of stated surveillance regimens with clinical practice guidelines; reporting details of follow-up, duration, loss to follow-up, & reasons for attrition; and reporting details of type & timing of adverse events & reinterventions peri- & post-TEVAR, in conjunction with implicated FDA-approved stent-graft designs. Additionally, quality control issues of the literature are heavily addressed via evaluation of variables’ reporting details.

Published
2023
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24. Endovascular Versus Open: Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta or Thoracotomy for Management of Post-Injury Noncompressible Torso Hemorrhage

Author

Roberts, Derek Jason, primary, Cotton, Bryan A., additional, Duchesne, Juan, additional, Ferrada, Paula, additional, Horer, Tal M., additional, Kauvar, David, additional, Khan, Mansoor, additional, Kirkpatrick, Andrew W., additional, Ordoñez, Carlos, additional, Perreira, Bruno, additional, Priouzram, Artai, additional, and Brenner, Megan L., additional

Published
2021
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26. Endovascular Versus Open: Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta or Thoracotomy for Management of Post-Injury Non-compressible Torso Hemorrhage

Author

Roberts, Derek J., Cotton, Bryan A., Duchesne, Juan, Ferrada, Paula, Horer, Tal M., Kauvar, David, Khan, Mansoor, Kirkpatrick, Andrew W., Ordonez, Carlos, Perreira, Bruno, Priouzram, Artai, Brenner, Megan L., Roberts, Derek J., Cotton, Bryan A., Duchesne, Juan, Ferrada, Paula, Horer, Tal M., Kauvar, David, Khan, Mansoor, Kirkpatrick, Andrew W., Ordonez, Carlos, Perreira, Bruno, Priouzram, Artai, and Brenner, Megan L.

Abstract

Non-compressible torso hemorrhage (NCTH) (i.e. bleeding from anatomical locations not amenable to control by direct pressure or tourniquet application) is a leading cause of potentially preventable death after injury. In select trauma patients with infra-diaphragmatic NCTH-related hemorrhagic shock or traumatic circulatory arrest, occlusion of the aorta proximal to the site of hemorrhage may sustain or restore spontaneous circulation. While the traditional method of achieving proximal aortic occlusion included Emergency Department thoracotomy (EDT) with descending thoracic aortic cross-clamping, resuscitative endovascular balloon occlusion of the aorta (REBOA) affords a less invasive option when thoracotomy is not required for other indications. In this article, we review the innovation, pathophysiologic effects, indications for, and technique of EDT and partial, intermittent, and complete REBOA in injured patients, including recommended methods for reversing aortic occlusion. We also discuss advantages and disadvantages of each of these methods of proximal aortic occlusion and review studies comparing their effectiveness and safety for managing post-injury NCTH. We conclude by providing recommendations as to when each of these methods may be best, when indicated, to manage injured patients with NCTH.

Published
2020
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27. Resuscitative endovascular balloon occlusion of the aorta: current evidence

Author

Osborn,Lesley A., Brenner,Megan L., Prater,Samuel J., and Moore,Laura J.

Subjects
Open Access Emergency Medicine
Abstract

Lesley A Osborn,1 Megan L Brenner,2 Samuel J Prater,1 Laura J Moore3 1Department of Emergency Medicine, The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA; 2Department of Surgery, The University of California – Riverside, Moreno Valley, CA, USA; 3Department of Surgery, The University of Texas Health Science Center, McGovern Medical School, Houston, TX, USA Abstract: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently gained popularity as a minimally invasive alternative to open aortic cross-clamping in the management of patients with non-compressible hemorrhage arising below the diaphragm. The purpose of this review is to provide a description of the technical aspects of REBOA use along with an overview of the current animal and clinical data regarding its use. Keywords: REBOA, hemorrhagic shock, resuscitation

Published
2019

28. Stop the Bleed: Does the Training Work One Month Out?

Author

Pasley, Amelia M., primary, Parker, Brandon M., additional, Levy, Matthew J., additional, Christiani, Anthony, additional, Dubose, Joseph, additional, Brenner, Megan L., additional, Scalea, Thomas, additional, and Pasley, Jason D., additional

Published
2018
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45. Blunt abdominal aortic injury

Author

Shalhub, Sherene, primary, Starnes, Benjamin W., additional, Brenner, Megan L., additional, Biffl, Walter L., additional, Azizzadeh, Ali, additional, Inaba, Kenji, additional, Skiada, Dimitra, additional, Zarzaur, Ben, additional, Nawaf, Cayce, additional, Eriksson, Evert A., additional, Fakhry, Samir M., additional, Paul, Jasmeet S., additional, Kaups, Krista L., additional, Ciesla, David J., additional, Todd, S. Rob, additional, Seamon, Mark J., additional, Capano-Wehrle, Lisa M., additional, Jurkovich, Gregory J., additional, and Kozar, Rosemary A., additional

Published
2014
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47. A Clinical Series of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhage Control and Resuscitation

Author

ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX, Brenner, Megan L, Moore, Laura J, DuBose, Joseph J, George H Tyson, McNutt, Michelle K, Albarado, Rondel P, Holcomb, John B, Scalea, Thomas M, Rasmussen, Todd E, ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX, Brenner, Megan L, Moore, Laura J, DuBose, Joseph J, George H Tyson, McNutt, Michelle K, Albarado, Rondel P, Holcomb, John B, Scalea, Thomas M, and Rasmussen, Todd E

Abstract

BACKGROUND: A requirement for improved methods of hemorrhage control and resuscitation along with the translation of endovascular specialty skills has resulted in reappraisal of resuscitative endovascular balloon occlusion of the aorta (REBOA) for end-stage shock. The objective of this report was to describe implementation of REBOA in civilian trauma centers. METHODS: Descriptive case series of REBOA (December 2012 to March 2013) used in scenarios of end-stage hemorrhagic shock at the University of Maryland, R. Adams Cowley Shock Trauma Center, Baltimore, Maryland, and Herman Memorial Hospital, The Texas Trauma Institute, Houston, Texas. RESULTS: REBOA was performed by trauma and acute care surgeons for blunt (n 4) and penetrating (n 2) mechanisms. Three cases were REBOA in the descending thoracic aorta (Zone I) and three in the infrarenal aorta (Zone III). Mean (SD) systolic blood pressure at the time of REBOA was 59 (27) mm Hg, and mean (SD) base deficit was 13 (5). Arterial access was accomplished using both direct cutdown (n 3) and percutaneous (n 3) access to the common femoral artery. REBOA resulted in a mean (SD) increase in blood pressure of 55 (20)mmHg, and the mean (SD) aortic occlusion time was 18 (34) minutes. There were no REBOA-related complications, and there was no hemorrhage-related mortality. CONCLUSION: REBOA is a feasible and effective means of proactive aortic control for patients in end-stage shock from blunt and penetrating mechanisms. With available technology, this method of resuscitation can be performed by trauma and acute care surgeons who have benefited from instruction on a limited endovascular skill set. Future work should be aimed at devices that allow easy, fluoroscopy-free access and studies to define patients most likely to benefit from this procedure., Published in the Journal of Trauma and Acute Care Surgery, v75 n3 p506-511, 2013. Prepared in collaboration with the Uniformed Service University of the Health Sciences, Baltimore, MD.

Published
2013

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