%0 Journal Article
%T The impact of intravascular ultrasound on outcomes of endovascular repair of blunt traumatic aortic injury
%A Brandon C Cain
%A David J Dexter
%A James C Etheridge
%A Jay N Collins
%A Jean M Panneton
%A S Sadie Ahanchi
%J Trauma
%@ 1477-0350
%D 2019
%R 10.1177/1460408618776333
%X Endovascular repair has become first-line therapy for traumatic aortic injury. Proper endograft sizing is critical to outcomes following traumatic aortic injury repair; however, the adequacy of standard imaging modalities for this purpose remains uncertain. We assessed the impact of intravascular ultrasound on outcomes of endovascular traumatic aortic injury repair. A retrospective review was conducted for all traumatic aortic injury patients from 2005 to 2015. Primary endpoints were 30-day aortic-related complications (aortic-related mortality, stroke, and spinal cord ischemia) and late device-related complications (collapse, migration, endoleak, and reintervention) over the duration of follow-up. Aortic measurements were calculated from three-dimensional-reconstructed computerized tomography studies and intravascular ultrasound images. Aortic remodeling was quantified by volume change between initial and first follow-up computerized tomography scans. Twenty-five patients were included (mean age 41, 72% male). Intravascular ultrasound was used in 14 patients. No differences in demographics or injury characteristics were observed between intravascular ultrasound and non-intravascular ultrasound patients. Proximal neck diameter was 1.2£¿mm greater on intraoperative intravascular ultrasound than initial computerized tomography imaging (P£¿=£¿.048). Endograft oversizing in relation to initial computerized tomography was 25% in intravascular ultrasound patients versus 9% in non-intravascular ultrasound patients (P£¿=£¿.001). No significant differences in aortic-related complications were noted. Device-related complications occurred more frequently in the non-intravascular ultrasound group at a mean follow-up of 252 days (36.4% vs. 0%, P£¿=£¿.026). Aortic remodeling rate was 4.41£¿cm3/day in the intravascular ultrasound group versus 2.34£¿cm3/day in the non-intravascular ultrasound group (P£¿=£¿.256). Intravascular ultrasound significantly impacts endograft sizing and was associated with decreased device-related complications following endovascular traumatic aortic injury repair
%K Traumatic aortic injury
%K blunt aortic injury
%K endovascular repair
%K intravascular ultrasound
%U https://journals.sagepub.com/doi/full/10.1177/1460408618776333