Why the study?
Does endovascular control of the aorta allow safe removal of periaortic pedicle screws without aortic grafting in patients with threatened aortic injury?
Does endovascular control of the aorta allow safe removal of periaortic pedicle screws without aortic grafting in patients with threatened aortic injury?
Hardware impinging on the aorta can be safely removed by gaining endovascular control, potentially avoiding the morbidity of aortic grafting if intraoperative aortography is normal.
May allow safe periaortic screw removal without grafting if aortography normal; leaves open generalizability beyond single cases.
Study Design Case report and review of the literature. Objective The objective of the article is to report the case of a 20-year-old patient with a threatened aortic injury from pedicle screw instrumentation successfully managed without aortic grafting. Methods The patient's clinical course is retrospectively reviewed. The offending hardware was removed after gaining endovascular control of the aorta. Results Intraoperative aortography was normal and no graft was placed. The patient remains asymptomatic at 2 years after surgery. Conclusions Hardware impinging on the aorta can safely be removed by gaining endovascular control of the aorta. In the setting of normal intraoperative aortography in a young patient, we recommend against further intervention to avoid the known morbidity of aortic grafting.
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Potter et al. (2013) studied this question.
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