Evidence map›Paper›PMID 34137003›Full record

ArticleGeneral thoracic and cardiovascular surgery2022

Retrospective study of thoracic endovascular aortic repair as a first-line treatment for traumatic blunt thoracic aortic injury.

So Izumi, Chikashi Nakai, Tomonori Haraguchi, Soichiro Henmi, Takeki Mori, Megumi Kinoshita, Masato Yamaguchi, Koji Sugimoto, Shinichi Nakayama, Takuro Tsukube

Abstract read
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In one paragraph

Article in General thoracic and cardiovascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

So IzumiDivision of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 1-3-1 Wakihama-kaigandori, Chuo-ku, Kobe, 651-0073, Japan.
Chikashi NakaiDivision of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 1-3-1 Wakihama-kaigandori, Chuo-ku, Kobe, 651-0073, Japan.
Tomonori HaraguchiDivision of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 1-3-1 Wakihama-kaigandori, Chuo-ku, Kobe, 651-0073, Japan.
Soichiro HenmiDivision of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 1-3-1 Wakihama-kaigandori, Chuo-ku, Kobe, 651-0073, Japan.
Takeki MoriDepartment of Radiology, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, Kobe, Japan.
Megumi KinoshitaDepartment of Radiology, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, Kobe, Japan.
Masato YamaguchiDepartment of Radiology, Graduate School of Medicine, Kobe University Hospital, Kobe, Japan.
Koji SugimotoDepartment of Radiology, Graduate School of Medicine, Kobe University Hospital, Kobe, Japan.
Shinichi NakayamaDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Japan.
Takuro TsukubeDivision of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 1-3-1 Wakihama-kaigandori, Chuo-ku, Kobe, 651-0073, Japan. t-tsukube@kobe.jrc.or.jp.ORCID http://orcid.org/0000-0002-6818-119X
Japanese Red Cross Kobe Hospital · JPKobe University Hospital · JPKobe Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study sought to confirm if thoracic endovascular aortic repair (TEVAR) was an appropriate therapeutic strategy for blunt thoracic aortic injury (BTAI).

methodsBetween 3/2005 and 12/2020, 104 patients with BTAI were brought to our hospital. The severity of each trauma case was evaluated using the Injury Severity Score (ISS); aortic injuries were classified as type I to IV according to Society for Vascular Surgery guidelines. Initial treatment was categorized into four groups: nonoperative management (NOM), open aortic repair (OAR), TEVAR, or emergency room thoracotomy/cardiopulmonary resuscitation (ERT/CPR).

resultsThe patients' mean age and ISS were 56.7 ± 20.9 years and 48.3 ± 20.4, respectively. Type III or IV aortic injury were diagnosed in 82 patients. The breakdown of initial treatments was as follows: NOM for 28 patients, OAR for four, TEVAR for 47, and ERT/CPR for 25. The overall early mortality rate was 32.7%. Logistic regression analysis confirmed ISS > 50 and shock on admission as risk factors for early mortality. The cumulative survival rate of all patients was 61.2% at 5 years after treatment. After initial treatment, eight patients receiving TEVAR required OAR. The cumulative rate of freedom from reintervention using TEVAR at 5 years was higher in approved devices than in custom-made devices (96.0 vs. 56.3%, p = 0.011).

conclusionsUsing TEVAR as an initial treatment for patients with BTAI is a reasonable approach. Patients with severe multiple traumas and shock on admission had poor early outcomes, and those treated with custom-made devices required significant rates of reintervention.

Indexed as

Endovascular ProceduresVascular System InjuriesWounds, NonpenetratingAorta, ThoracicHospital MortalityHumansRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeBlunt thoracic aortic injuryMultiple traumaNonoperative managementOpen aortic repairThoracic endovascular aortic repair

Identifiers

PMID34137003
OpenAlexW3167267126

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.