title: Traumatic injury of the thoracic aorta treated with stent-graft: is long-term CT angiography follow-up justified?
abstract: OBJECTIVE
  To report the results of long-term (>5 years) computed tomography (CT) angiography follow-up after thoracic endovascular aortic repair in patients with traumatic thoracic aortic injury.
  
  
  METHODS
  All follow-up CT angiographies performed in patients with traumatic thoracic aorta injury treated by endovascular stent-graft between 2002 and 2008 were reviewed. Of the 14 patients treated, seven patients had CT angiography follow-up examinations for more than 5 years. All patients were men with a mean age of 26 years. The Talent device was used in four patients and Gore TAG device in three patients. The mean device diameter and length were 24.6 mm and 103 mm, respectively. Follow-up included annual outpatient clinic surveillance and CT angiography examinations, which were reviewed for any device-related complications. The radiation effective dose was calculated from the CT dose report.
  
  
  RESULTS
  Thirty-three CT examinations performed 64-110 months (mean 76) after stent-graft implementation were reviewed. The mean follow-up number of examinations per patient was 4.7 (range 2-8). Intra-graft circular mural tissue at the distal part of the stent-graft was seen in one patient. Stable lack of proximal device apposition was seen in all patients. No other radiological complications (e.g., aortic infection, dilatation, aneurysm or pseudoaneurysm, device struts breakage, migration, collapse, endoleak) were detected. None of the patients developed hypertension. The average effective dose was 77.01 mSv (range 34.11-128.84 mSv).
  
  
  CONCLUSIONS
  CT angiography did not reveal any complications developing throughout the long-term follow-up. These results suggest that long-term CT angiography follow-up may not be required.
authors.affiliation: Diagnostic Imaging, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: rimonu@sheba.health.gov.il.
authors.forename: U
authors.initials: U
authors.lastname: Rimon
authors.affiliation: Cardiac Surgery, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shinfeld
authors.affiliation: Nuclear Medicine Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Gayer
mesh_terms: D000328:Adult; D000792:Angiography; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D017410:Practice Guidelines as Topic; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019564:Unnecessary Procedures; D014947:Wounds and Injuries / Q000000981:diagnostic imaging* / Q000601:surgery