OPEN IN READ APP
JOURNAL ARTICLE

Optimal management of traumatic aortic injury

R Fattori, V Russo, L Lovato, R Di Bartolomeo
European Journal of Vascular and Endovascular Surgery 2009, 37 (1): 8-14
19008125

BACKGROUND: The best time to intervene in traumatic aortic injuries has long been a matter of debate. While emergency surgery is characterized by high morbidity and mortality, initial medical management of uncomplicated aortic injury and subsequent delayed surgery resulted in better outcome.

METHODS AND RESULTS: From analysis of medical literature of the last 10 years, major paradigm shift in management of traumatic injuries includes the use of different imaging methods for diagnosis, with a almost complete elimination of aortography and transesophageal echocardiography in favour of CT scan, and a significant change in method of definitive repair, shifting from exclusively open techniques in 1997 to predominantly endovascular repairs in 2007. At present several reports in literature provide data on comparative results of endovascular therapy with respect open surgery, supporting the use of stent-graft in traumatic injuries, both in acute and chronic cases. The authors' personal experience comprises 58 patients treated with endovascular stent-graft repair, with no mortality or treatment failure even during 11 years follow-up.

CONCLUSIONS: For many years traumatic aortic injury has been considered a highly lethal lesion and a potential cause of death in blunt chest trauma. Because of the lower invasivity endovascular repair can be applied in traumatic aortic injury with very low risk and limited impact on trauma destabilization. Long term follow-up seems indicate a substantial durability of the procedure.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
19008125
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"