Evaluation of Endovascular Intervention for Tracheo-Innominate Artery Fistula: A Systematic Review
| Autor: | H. Todd Massey, Vakhtang Tchantchaleishvili, John W. Entwistle, Kyle W. Prochno, Rohinton J. Morris, Babak Abai, T. Sloane Guy, Thomas J. O’Malley, Elizabeth J. Maynes, Abhiraj Saxena, Andrew M. Jordan, Brandon Ferrell |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Standard of care Adolescent 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Risk Factors Intervention (counseling) medicine Humans Brachiocephalic Trunk Vascular Fistula Tracheal Diseases business.industry Artery fistula Endovascular Procedures General Medicine Perioperative Length of Stay Middle Aged Surgery Treatment Outcome Endovascular interventions Female Stents Respiratory Tract Fistula Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Vascular and endovascular surgery. 55(4) |
| ISSN: | 1938-9116 |
| Popis: | Background:While the standard of care for suspected tracheo-innominate artery fistula (TIF) necessitates sternotomy, perioperative mortality remains high. Endovascular interventions have been attempted, but reports have been anecdotal. The aim of this systematic review was to evaluate the outcomes of endovascular management of TIF by pooling the existing evidence.Methods:An electronic database search of Ovid MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Controlled Trials Register was performed to identify all studies examining endovascular treatment of TIF. Patients greater than 14 years of age who underwent endovascular intervention for TIF were included. 25 studies consisting of 27 patients met the inclusion criteria.Results:48.1% (13/27) of patients were male and median age was 39.0 [IQR 16.0, 47.5] years. Tracheostomy was present in 96.3% (26/27) of cases. Median duration from tracheostomy to TIF presentation was 2.2 months [0.5, 42.5]. On presentation, 84.6% (22/26) had tracheal hemorrhage, and 22.8% (6/27) were hemodynamically unstable. 96.3% (26/27) underwent covered stent graft placement while 1 patient (3.8%) had coil embolization. 18.5% (5/27) of patients required repeat endovascular intervention for recurrent bleeding, while 11.1% (3/27) required rescue sternotomy. Median hospital length of stay was 30 days [16.0, 46.5], and overall mortality was 29.6% (8/27) with a median follow-up time of 5 months [1.2, 11.5].Conclusion:While uncommon, endovascular treatment of TIF may be a feasible alternative to sternotomy. The approach may be useful in those who are unable to undergo surgery or are likely to have adhesions from prior chest operations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|