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Thu Aug 10 00:33:41 BST 2006

I fear the thoracic endografts are driven by industry, not real clear indications.  All over the US I note that the QA and UR for endografts is much more lax than open procedures.  IR and cardiology have al¤ost no oversight.  

K

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-----Original Message-----
From: "Ronald Gross" <Rgross at harthosp.org>
Date: Wed, 09 Aug 2006 19:10:20 
To:<trauma-list at trauma.org>
Subject: Re: SGW to Femoral triangle - Synthetic vs "autogenous"

AMEN!! 

>>> <KMATTOX at aol.com> 8/9/2006 6:38 PM >>>

In a message dated 8/9/2006 5:34:48 P.M. Central Standard Time,  
vascular at ekit.com writes:

Are you  guys using more and
more Endovascular Stent Grafts in this population  ?  What is your gut
feeling about the results and durability  ?

We are using less and less.   Our skepticism is increasing.   I am 
discovering many in the literature and around the country are put into 
aortas that I do 
not see a real injury.   The smallest approved  thoracic aortic graft
is far 
too big for most young aortas.   Then a  problem of enfolding occurs.  

NO ONE SHOULD BE GETTING A THORACIC ENDOGRAFT PLACED FOR TRAUMA UNLESS
IT  IS 
PART OF A RIGID RESEARCH PROTOCOL WITH SOMEONE ON THE PROTOCOL WHO
REVIEWS  
EACH CASE AND WHO IS ALSO A SKEPTIC AND SOMEONE WHO IS A  CHAMPION.    

I am very very concerned about the use of these grafts in patients with

minimal to no injury.  

k
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SGW to Femoral triangle - Synthetic vs "autogenous"