Evidence map›Paper›PMID 36931613›Full record

ArticleJournal of vascular surgery2023

Outcomes following thoracic endovascular aortic repair for blunt thoracic aortic injury stratified by Society for Vascular Surgery grade.

Sai Divya Yadavalli, Anne-Sophie C Romijn, Vinamr Rastogi, Steven P Summers, Christina L Marcaccio, Sara L Zettervall, Mohammad H Eslami, Benjamin W Starnes, Hence J M Verhagen, Marc L Schermerhorn

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
4.7field-weighted citation impact, top 5% 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

6 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
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  6. Blunt Thoracic Aortic Injury.Journal of clinical medicine · 2023
    Review
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 4 institutions in 2 countries.

Sai Divya YadavalliDivision of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Anne-Sophie C RomijnDivision of Trauma & Emergency Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Surgery, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands.
Vinamr RastogiDivision of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
Steven P SummersDivision of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; School of Medicine, Virginia Commonwealth University, Richmond, VA.
Christina L MarcaccioDivision of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Sara L ZettervallDivision of Vascular Surgery, Department of Surgery, University of Washington, Seattle, WA.
Mohammad H EslamiDivision of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Benjamin W StarnesDivision of Vascular Surgery, Department of Surgery, University of Washington, Seattle, WA.
Hence J M VerhagenDivision of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
Marc L SchermerhornDivision of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: mscherm@bidmc.harvard.edu.
Beth Israel Deaconess Medical Center · USUniversity of Washington · USHarvard University · USUniversity of Pittsburgh Medical Center · US

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Disparities in Detection and Treatment of Abdominal Aortic Aneurysm DiseaseF32HS027285 · AHRQ · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCACCIO, CHRISTINA · 2020 to 2021
$154k
AHRQ HHS F32 HS027285NCATS NIH HHS UL1 TR002541
6 · The paper itself

Abstract

objectivesAlthough the Society for Vascular Surgery (SVS) aortic injury grading system is used to depict the severity of injury in patients with blunt thoracic aortic injury, prior literature on its association with outcomes after thoracic endovascular aortic repair (TEVAR) is limited.

methodsWe identified patients undergoing TEVAR for BTAI within the VQI between 2013 and 2022. We stratified patients based on their SVS aortic injury grade (grade 1, intimal tear; grade 2, intramural hematoma; grade 3, pseudoaneurysm; and grade 4, transection or extravasation). We assessed perioperative outcomes and 5-year mortality using multivariable logistic and Cox regression analyses. Secondarily, we assessed the proportional trends in patients undergoing TEVAR based on SVS aortic injury grade over time.

resultsOverall, 1311 patients were included (grade1, 8%; grade 2, 19%; grade 3, 57%; grade 4, 17%). Baseline characteristics were similar, except for a higher prevalence of renal dysfunction, severe chest injury (Abbreviated Injury Score >3), and lower Glasgow Coma Scale with increasing aortic injury grade (P

conclusionsAfter TEVAR for BTAI, there was higher perioperative and 5-year mortality in patients with grade 4 BTAI. However, after risk adjustment, there was no association between SVS aortic injury grade and perioperative and 5-year mortality in patients undergoing TEVAR for BTAI. More than 5% of patients with BTAI who underwent TEVAR had a grade 1 injury, with a concerning rate of spinal cord ischemia potentially attributable to TEVAR, and this proportion did not decrease over time. Further efforts should focus on enabling careful selection of patients with BTAI who will experience more benefit than harm from operative repair and preventing the inadvertent use of TEVAR in low-grade injuries.

Indexed as

Aortic DiseasesEndovascular ProceduresSpinal Cord IschemiaThoracic InjuriesVascular System InjuriesWounds, NonpenetratingAorta, ThoracicEndovascular Aneurysm RepairHumansRetrospective StudiesRisk FactorsTime FactorsTreatment OutcomeBlunt thoracic aortic injurySVS Aortic Injury GradingTEVARThoracic injury

Identifiers

PMID36931613
PMCPMC10293110
OpenAlexW4324387314

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.