Is Faster Better? An Aortic Trauma Foundation Database Analysis of Aortic Injury Repair Timing

Although pseudoaneurysms after penetrating extremity trauma are well described, we describe an unusual case of residual occult aortic injury after an initial attempt at repair that was recognized on postoperative imaging. Reoperation with primary resection and end-to-end repair was accomplished successfully. Because this entity is so unusual, we review strategies to avoid and recognize its occurrence. Early imaging allows early identification of aortic pseudoaneurysms should they occur, and will preclude delayed manifestation of complications, including death. Our case illustrates the utility of such postoperative scanning. Other alternatives to primary repair or interposition grafting in management of penetrating abdominal aortic trauma, such as interventional stent grafting, are discussed.

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1348: Postoperative Complications of Endovascular Blunt Thoracic Aortic Injury Repair

Critical Care Medicine ◽

10.1097/01.ccm.0000731280.00929.a9 ◽

2020 ◽

Vol 49 (1) ◽

pp. 681-681

Author(s):

Hossam Abdou ◽

Rishi Kundi ◽

Noha Elansary ◽

Joseph DuBose ◽

Thomas Scalea ◽

...

Keyword(s):

Postoperative Complications ◽

Aortic Injury ◽

Injury Repair ◽

Blunt Thoracic Aortic Injury ◽

Thoracic Aortic Injury

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Trend of management of traumatic thoracic aortic injuries in a single center

Vascular ◽

10.1177/1708538112474259 ◽

2013 ◽

Vol 22 (2) ◽

pp. 134-141 ◽

Cited By ~ 1

Author(s):

Bibombe P Mwipatayi ◽

Arwen Boyle ◽

Michael Collin ◽

Jean-Louis Papineau ◽

Vikram Vijayan

Keyword(s):

Endovascular Repair ◽

Paradigm Shift ◽

Injury Severity ◽

Average Length ◽

Length Of Hospital Stay ◽

Aortic Injury ◽

Thoracic Aortic Injury ◽

Aortic Injuries ◽

The Mean ◽

Aortic Trauma

The purpose of this study was to review the shift in the trend of management and mid-term outcomes of all patients who sustain thoracic aortic injury. A Retrospective analysis was performed of all patients sustaining blunt thoracic aortic trauma admitted to our unit. Forty-seven patients were presented with injury to the thoracic aorta following blunt chest injury. Ten patients underwent open surgical repair of their thoracic aortic injury. The mean age ± SD (range) was 29.4 ± 7.9 years (18–41) with a mean Injury Severity Score (ISS) of 41 ± 14.7 (25–75). Fifteen patients underwent thoracic endovascular repair for blunt aortic transections with a mean age of 35.1 ± 14.5 years (17–65), mean ISS of 40.8 ± 13.9 (20–75) and an average length of hospital stay of 25.6 ± 14.5 days (3–77). The mean aortic diameter proximal to the aortic injury was 23.46 ± 3.02 mm (19–28) with a mean aortic angulation of 58.46° ± 17.73 (44–80°). The mean oversizing was 24.4 ± 5.4% (17–32%). At our institution, there has been a paradigm shift in the emergent repair of blunt thoracic aortic injury from open surgery to endovascular repair. Oversizing of the stent-graft did not translate to a poorer outcome.

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Outcomes of TEVAR in Patients with Concomitant Blunt Thoracic Aortic Injury and Traumatic Brain Injury from The Aortic Trauma Foundation Global Registry

Journal of Vascular Surgery ◽

10.1016/j.jvs.2021.09.028 ◽

2021 ◽

Author(s):

Cassra N. Arbabi ◽

Joseph DuBose ◽

Benjamin W. Starnes ◽

Naveed Saqib ◽

Elina Quiroga ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Aortic Injury ◽

Blunt Thoracic Aortic Injury ◽

Thoracic Aortic Injury ◽

Global Registry ◽

Aortic Trauma

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Isolated Abdominal Injury of Blunt Aortic Trauma

Journal of Endovascular Resuscitation and Trauma Management ◽

10.26676/jevtm.v2i3.63 ◽

2018 ◽

Vol 2 (3) ◽

Author(s):

Barak Raguan ◽

Ali Shnaker ◽

Simone Fajer

Keyword(s):

Abdominal Aorta ◽

Endovascular Repair ◽

Open Repair ◽

Rare Event ◽

Aortic Injury ◽

Abdominal Injury ◽

Blunt Injury ◽

Abdominal Injuries ◽

Abdominal Aortic ◽

Aortic Trauma

Background: Injury to the abdominal aorta as part of a blunt injury is a rare event and is normally associated with other abdominal injuries. The management of these injuries can be non-operative, open repair or endovascular repair. Methods: We present two cases of blunt abdominal aortic injury in which the aorta was the only abdominal injury. This is followed by a review of the current literature. Results: Both these cases were treated endovascularly with good results. Conclusions: BAAIs are rare, and can occur in isolation, i.e. without any accompanying abdominal injuries. Despite historically being treated mostly by open repair, endovascular repair offers many advantages and can be safely managed.

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Pictorial review on the endovascular management of paediatric aortic injuries

British Journal of Radiology ◽

10.1259/bjr.20190017 ◽

2020 ◽

Vol 93 (1106) ◽

pp. 20190017

Author(s):

Neville W Nicholas ◽

David R Shaw ◽

Sapna Puppala

Keyword(s):

Gold Standard ◽

Surgical Repair ◽

Vascular Anatomy ◽

Aortic Injury ◽

Pictorial Representation ◽

Endovascular Management ◽

Rare Injury ◽

Pictorial Review ◽

Aortic Injuries ◽

Aortic Trauma

Paediatric aortic trauma is a rare injury which can be fatal if not identified and managed appropriately. Surgical repair remains the gold-standard in moderate to severe aortic injuries. In the last decade however, endovascular treatment has gained popularity in children who have suitable vascular anatomy for intervention and are either not fit for surgery or in whom, endovascular intervention is the only alternative that will make a difference in the clinical outcome. Children pose a unique set of challenges to endovascular therapy. In this article, we aim to illustrate the different endovascular options that are available for the treatment of acute traumatic aortic injury and visceral thromboembolisation through pictorial representation. We will also demonstrate the feasibility and the limitation of this technique.

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Thoracic Aortic Injury: Embolization of the Tenth Intercostal Artery and Endovascular Treatment in a Young Woman after Posterior Spinal Instrumentation

Case Reports in Vascular Medicine ◽

10.1155/2015/531201 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Konstantinos Lagios ◽

Georgios Karaolanis ◽

Theodossios Perdikides ◽

Theodoros Bazinas ◽

Nikolaos Kouris ◽

...

Keyword(s):

Spinal Instrumentation ◽

Pedicle Screws ◽

Aortic Injury ◽

Time Interval ◽

Spinal Cord Blood Flow ◽

Pseudoaneurysm Formation ◽

Hematoma Formation ◽

Thoracic Aortic Injury ◽

Aortic Injuries ◽

Aortic Trauma

Iatrogenic aortic injuries are rare and well-recognized complications of a variety of procedures, including spinal surgery. The placement of pedicle screws is sometimes associated with devastating consequences. Aortic perforation with rapid hematoma formation and delayed aortic trauma leading to pseudoaneurysm formation have been described in the literature. A case describing a significant time interval between iatrogenic aortic injury and diagnosis in the absence of pseudoaneurysm formation is described in this paper and, according to our knowledge, is unique in the literature. The aortic injury was successfully treated, selecting the appropriate graft and, as a consequence, normal spinal cord blood flow was achieved.

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