Abstract
Blunt traumatic aortic injury is associated with significant mortality, and increased computed tomography use identifies injuries not previously detected. This study sought to define parameters identifying patients who can benefit from medical management. We reviewed 4.5 years of blunt traumatic aortic injuries. Injury was classified as grade I (intimal flap or intramural hematoma), II (small pseudoaneurysm <50% circumference), III (large pseudoaneurysm >50% circumference), and IV (rupture/transection). Secondary signs of injury included pseudocoarctation, extensive mediastinal hematoma, and large left hemothorax. Follow-up, including computed tomography, was reviewed. We identified 97 patients: 31 grade I, 35 grade II, 24 grade III, and 7 grade IV; 67(69%) male; mean age 47 ± 18.8 years, mean Injury Severity Score 38.8 ± 14.6; overall survival 76 (78.4%). Secondary signs of injury were found in 30 patients. Overall, 52 (53.6%) underwent repair, 45 undergoing thoracic endovascular aortic repair, with 2 (2.22%) procedure-related deaths, and 7 undergoing open repair. Five patients undergoing thoracic endovascular aortic repair required 7 additional procedures. In 45 medically managed patients, there were 14 deaths (31%), all seco...Continue Reading
References
Apr 1, 1981·The Annals of Thoracic Surgery·C W AkinsW G Austen
Dec 11, 1997·Radiology·N KatoS T Kee
Dec 5, 1998·World Journal of Surgery·J W PateT C Fabian
Jun 11, 1999·Radiologic Clinics of North America·M L Gavant
Mar 7, 2001·The Journal of Trauma·H M BurkhartT A Broadie
Dec 12, 2001·The Journal of Trauma·A K MalhotraJ W Pate
Jun 1, 1958·Circulation·L F PARMLEYE J JAHNKE
May 9, 2006·The Journal of Thoracic and Cardiovascular Surgery·Andrea AgostinelliTiziano Gherli
Mar 12, 2008·The Journal of Trauma·Demetrios DemetriadesUNKNOWN American Association for the Surgery of Trauma Thoracic Aortic Injury Study Group
Oct 17, 2008·The New England Journal of Medicine·David G NeschisBartley P Griffith
Apr 11, 2009·The Journal of Trauma·Demetrios DemetriadesLinda S Chan
Jun 6, 2009·Journal of Vascular Surgery·Ali AzizzadehAnthony L Estrera
May 18, 2010·Journal of Vascular Surgery·Jennifer L LangR James Valentine
Jun 29, 2010·The Journal of Thoracic and Cardiovascular Surgery·Anthony D CaffarelliR Scott Mitchell
Oct 27, 2010·Journal of Vascular Surgery·W Anthony LeeRonald M Fairman
Jan 29, 2011·The Journal of Thoracic and Cardiovascular Surgery·Victor X MosqueraJosé J Cuenca
Dec 2, 2011·Journal of Vascular Surgery·Benjamin W StarnesGabriel Aldea
Dec 21, 2011·The Journal of Trauma·Jasmeet S PaulKaren Brasel
Dec 22, 2011·The Annals of Thoracic Surgery·Joseph RabinThomas M Scalea
Citations
May 27, 2014·The Annals of Thoracic Surgery·Joseph RabinRobert S Crawford
Jul 16, 2014·Annals of Vascular Surgery·Donald G HarrisRobert S Crawford
Nov 18, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Takashi TagamiHideo Yasunaga
Mar 12, 2016·Annals of Vascular Surgery·A GombertJ Kalder
Aug 11, 2015·Annals of Vascular Surgery·Shao-Wei ChenPo-Jen Ko
Jul 6, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·J SteuerT Pfammatter
Jul 1, 2015·Diagnostic and Interventional Imaging·F Z MokraneH Rousseau
Sep 10, 2014·Journal of Vascular Surgery·Donald G HarrisRobert S Crawford
Mar 2, 2016·Journal of Vascular Surgery·Gerald R FortunaAli Azizzadeh
Oct 21, 2016·Journal of Vascular Surgery·Donald G HarrisRobert S Crawford
Jun 3, 2016·Journal of Surgical Case Reports·John Alfred Carr
Jun 7, 2016·Annals of Vascular Surgery·Donald G HarrisRobert S Crawford
Mar 28, 2017·PloS One·Alexander GombertJochen Grommes
Jan 28, 2017·The Journal of Trauma and Acute Care Surgery·Megan BrennerThomas Scalea
Aug 3, 2017·Vascular and Endovascular Surgery·Milan JovanovicZoran Rancic
Sep 20, 2018·VASA. Zeitschrift für Gefässkrankheiten·Elizabeth L ChouMatthew J Eagleton
May 5, 2017·The Journal of Cardiovascular Surgery·Cornelis P van der ZeeMaarten J van der Laan
Mar 12, 2019·The Journal of Cardiovascular Surgery·Anna N Romagnoli, Joseph Dubose
Mar 11, 2015·The Journal of Trauma and Acute Care Surgery·Joseph J DuBoseUNKNOWN Aortic Trauma Foundation
Mar 10, 2016·The Journal of Trauma and Acute Care Surgery·Matthew R SmedsAhsan T Ali
Oct 3, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Harit KapoorMarianna Zagurovskaya
Apr 17, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Victor X MosqueraJosé Cuenca-Castillo
Feb 13, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Daisuke KaneyukiHiroyuki Nakajima
Jan 13, 2017·Cardiovascular and Interventional Radiology·Prashant NagpalAshish Khandelwal
Sep 2, 2018·Medicine·Yusuke KatayamaTakeshi Shimazu
Nov 6, 2015·Current Opinion in Critical Care·Neil G ParryKelly Vogt
Mar 15, 2018·Emergency Radiology·John H HarrisAmy M Trahan
Nov 24, 2020·Annals of Vascular Surgery·Samuel CassidyDaniel Ablett
Sep 24, 2020·The Journal of Cardiovascular Surgery·Ilenia D'alessioSanti Trimarchi
Jan 18, 2020·Journal of Vascular and Interventional Radiology : JVIR·Siddharth A PadiaSue E Hanks
Oct 17, 2020·Vascular and Endovascular Surgery·Daniel ChengPaul J Chestovich
Dec 29, 2020·Annals of Vascular Surgery·Elina QuirogaNiten Singh
Aug 26, 2019·Journal of Vascular Surgery·Tse Kiat SoongAndrew M T L Choong
Mar 30, 2019·Journal of Vascular Surgery·Elina QuirogaNiten Singh
May 28, 2019·Journal of Vascular Surgery·Jean Jacob-BrassardCharles de Mestral