Abstract
Traumatic aortic injuries are most commonly associated with rapid deceleration injuries and are the second most common cause of deaths due to blunt trauma. Only 10–20% of traumatic aortic injury patients make it to the emergency department alive, of those, only 60–70% survive. Prompt diagnosis of aortic injury is achieved with defined clinical presentations driving early CTA. In hemodynamically unstable patients, urgent aortic repair is key to survival. High technical success rate, low procedural complication rate, and low 30-day mortality rate can be expected with thoracic endovascular aortic repair (TEVAR), superior to the results previously obtained with open aortic repair.
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References
Thompson MM, Morgan RA, Matsumura JS, Sapoval M, Loftus IM. Endovascular intervention for vascular disease: principles and practice. Informa Healthcare: New York; 2007.
Fabian TC, Richardson JD, Croce MA, Smith JS Jr, Rodman G Jr, Kearney PA, et al. Prospective study of blunt aortic injury: multicenter trial of the American Association for the Surgery of Trauma. J Trauma. 1997;42(3):374–80. discussion 380-3.
Cardarelli MG, McLaughlin JS, Downing SW, Brown JM, Attar S, Griffith BP. Management of traumatic aortic rupture: a 30-year experience. Ann Surg. 2002;236(4):465–9. discussion 469-70.
Smith RS, Chang FC. Traumatic rupture of the aorta: still a lethal injury. Am J Surg. 1986;152(6):660–3.
Svensson LG. Descending thoracic and thoracoabdominal aortic surgery. In: Sabiston and Spencer’s surgery of the chest. 7th ed. Philadelphia: Elsevier Saunders; 2005.
Cohen AM, Crass JR. Traumatic aortic injuries: current concepts. Semin Ultrasound CT MR. 1993;14(2):71–84.
Javadpour H, O'Toole JJ, McEniff JN, Luke DA, Young VK. Traumatic aortic transection: evidence for the osseous pinch mechanism. Ann Thorac Surg. 2002;73(3):951–3.
Nagpal P, Mullan BF, Sen I, Saboo SS, Khandelwal A. Advances in imaging and management trends of traumatic aortic injuries. Cardiovasc Intervent Radiol. 2017;40(5):643–54.
Svensson LG. Traumatic injuries of the aorta. In: Svensson LG, Crawford ES, editors. Cardiovascular and vascular disease of the aorta. Philadelphia: WB Saunders; 1997. p. 184–91.
Rabinsky I, Sidhu GS, Wagner RB. Mid-descending aortic traumatic aneurysms. Ann Thorac Surg. 1990;50(1):155–60.
Groskin SA. Selected topics in chest trauma. Radiology. 1997;183:605–17.
Azizzadeh A, Keyhani K, Miller CC 3rd, Coogan SM, Safi HJ, Estrera AL. Blunt traumatic aortic injury: initial experience with endovascular repair. J Vasc Surg. 2009;49(6):1403–8.
Chen SW, Wang SY, Liao CH, Huang YK, Liu KS, Lin PJ, et al. Timing of intervention in blunt traumatic aortic injury patients: open surgical versus endovascular repair. Ann Vasc Surg. 2015;29(8):1559–66.
Sammer M, Wang E, Blackmore CC, Burdick TR, Hollingworth W, Indeterminate CT. Angiography in blunt thoracic trauma: is CT angiography enough? AJR Am J Roentgenol. 2007;189(3):603–8.
Fox N, Schwartz D, Salazar JH, Haut ER, Dahm P, Black JH, et al. Evaluation and management of blunt traumatic aortic injury: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2015;78(1):136–46.
Jamieson WR, Janusz MT, Gudas VM, Burr LH, Fradet GJ, Henderson C. Traumatic rupture of the thoracic aorta: third decade of experience. Am J Surg. 2002;183(5):571–5.
Cowley RA, Turney SZ, Hankins JR, Rodriguez A, Attar S, Shankar BS. Rupture of thoracic aorta caused by blunt trauma. A fifteen-year experience. J Thorac Cardiovasc Surg. 1990;100(5):652–60. discussion 660-1.
Ott MC, Stewart TC, Lawlor DK, Gray DK, Forbes TL. Management of blunt thoracic aortic injuries: endovascular stents versus open repair. J Trauma. 2004;56(3):565–70.
Kato N, Dake MD, Miller DC, Semba CP, Mitchell RS, Razavi MK, et al. Traumatic thoracic aortic aneurysm: treatment with endovascular stent-grafts. Radiology. 1997;205(3):657–62.
Bell RE, Taylor PR, Aukett M, Sabharwal T, Reidy JF. Results of urgent and emergency thoracic procedures treated by endoluminal repair. Eur J Vasc Endovasc Surg. 2003;25(6):527–31.
Czermak BV, Fraedrich G, Perkmann R, Mallouhi A, Steingruber IE, Waldenberger P, et al. Endovascular repair of thoracic aortic disease: what we have learned. Curr Probl Diagn Radiol. 2004;33(6):269–82.
Iannelli G, Piscione F, Di Tommaso L, Monaco M, Chiariello M, Spampinato N. Thoracic aortic emergencies: impact of endovascular surgery. Ann Thorac Surg. 2004;77(2):591–6.
Scheinert D, Krankenberg H, Schmidt A, Gummert JF, Nitzsche S, Scheinert S, et al. Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta. Eur Heart J. 2004;25(8):694–700.
Wellons ED, Milner R, Solis M, Levitt A, Rosenthal D. Stent-graft repair of traumatic thoracic aortic disruptions. J Vasc Surg. 2004;40(6):1095–100.
Lachat M, Pfammatter T, Witzke H, Bernard E, Wolfensberger U, Künzli A, et al. Acute traumatic aortic rupture: early stent-graft repair. Eur J Cardiothorac Surg. 2002;21(6):959–63.
Morishita K, Kurimoto Y, Kawaharada N, Fukada J, Hachiro Y, Fujisawa Y, et al. Descending thoracic aortic rupture: role of endovascular stent-grafting. Ann Thorac Surg. 2004;78(5):1630–4.
Reed AB, Thompson JK, Crafton CJ, Delvecchio C, Giglia JS. Timing of endovascular repair of blunt traumatic thoracic aortic transections. J Vasc Surg. 2006;43(4):684–8.
Xenos ES, Abedi NN, Davenport DL, Minion DJ, Hamdallah O, Sorial EE, et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg. 2008;48(5):1343–51.
Martin C, Thony F, Rodiere M, Bouzat P, Lavagne P, Durand M, et al. Long-term results following emergency stent graft repair for traumatic rupture of the aortic isthmus. Eur J Cardiothorac Surg. 2017;51(4):767–72.
Orford VP, Atkinson NR, Thomson K, Milne PY, Campbell WA, Roberts A, et al. Blunt traumatic aortic transection: the endovascular experience. Ann Thorac Surg. 2003;75(1):106–11. discussion 111-2.
Bortone AS, De Cillis E, D'Agostino D, Schinosa Lde L. Stent graft treatment of thoracic aortic disease. Surg Technol Int. 2004;12:189–93.
Cambria RP, Brewster DC, Lauterbach SR, Kaufman JL, Geller S, Fan CM, et al. Evolving experience with thoracic aortic stent graft repair. J Vasc Surg. 2002;35(6):1129–36.
Fattori R, Napoli G, Lovato L, Russo V, Pacini D, Pierangeli A, et al. Indications for, timing of, and results of catheter-based treatment of traumatic injury to the aorta. AJR Am J Roentgenol. 2002;179(3):603–9.
Saratzis AS, Fillipou D, Melas N, Kiskinis D. Endovascular stent-graft repair of an Aortobronchial Fistula: case report and review of the literature. EJVES Extra. 2005;9:123–5.
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Hagar, M.J., Salaskar, A.L., Sarin, S. (2018). Traumatic Aortic Injury. In: Keefe, N., Haskal, Z., Park, A., Angle, J. (eds) IR Playbook. Springer, Cham. https://doi.org/10.1007/978-3-319-71300-7_20
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