Clinic analysis of treatment for injuries of supra-arch branches / 国际外科学杂志

ABSTRACT

Objective To analyse the initial resucts in different treatment methods for the treatment of aortic arch injury.Methods A total of 23 patients (18 males and 5 females) with injuries of superior arch arteries underwent our treatment in Shandong Provincial Hospital Affiliated to Shandong University from January 2008 to May 2017.Nine patients underwent surgical procedures(surgical group),13 patients underwent endovascular procedures (endovascular group),1 patient underwent conservative treatment.The conditions of all survived patients were followed up by telephone or outpatient from one to sixty months postoperative.Mortality and complications such as rehaemorrhagia,cerebralinfarction,stenosis or blockage during the follow-up period was assessed.Operation time,hospitalization time after treatment,mortality and complications within 30 days of surgical group and endovascular group were compared by statistical methods.The data were analyzed by SPSS 16.0 software.Measurement data were expressed as ((x) ± s).The count data were expressed as frequency and percentage (％),and comparison between groups were evaluated with t test,Chi-square.Results All patients had achieved technical success.In patients treated by surgical procedures,one case of death and 2 cases of cerebralinfarction were reported within 30 days.One patient died of rehaemorrhagia during the 2nd day of open operation.Meanwhile,another two patients suffered from cerebral infarction,they recovered within 30 days.All patients treated by endovascular procedures survived without cerebralinfarction.However,blockage occurred in one patient of these patients.The operation time [(2.4 ± 1.1) hours and (1.0 ± 0.4) hours] (P ＜ 0.01) and the time of postoperative hospitalization [(8.3 ± 3.0) days and(2.5 ± 1.0) days] (P ＜ 0.05) were statistically different of the two groups.The postoperative mortality rate of the two groups undergoing open surgery and endovascular treatment within 30 days was 11.1％ and 0.0％ (P =0.41),and complication rates with 33.3％ and 7.7％ respectively (P =0.26),there has no significant difference.Overall,66.7％ (6/9) patients treated by surgical procedures and 92.3％ (12/13) patients treated by endovascular procedures and one patient treated by consewative treatment survived without any complication during the follow up period.Conclusions Initial results suggest that endovascular procedures can significantly shorten the time of operation and the time of postoperative hospitalization,and the mortality and complication rate are also slightly lower than surgical procedures.Endovascular procedures is an important method for treatment for injuries that involve superior arch arteries.It plays a special role in rescuing injuries of superior arch arteries.