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

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
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.

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

Vascular ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 134-141 ◽  
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.

Improving Surveillance of Traumatic Thoracic Aortic Injuries Repaired with Thoracic Endovascular Graft Placement

2018 ◽  
Vol 84 (7) ◽  
pp. 1129-1132
Author(s):  
Nathan A. Ludwig ◽  
Neal Bhutiani ◽  
Paul L. Linsky ◽  
Amit J. Dwivedi ◽  
Matthew C. Bozeman
Keyword(s):  
Injury Severity ◽  
Vascular Complications ◽  
Aortic Injury ◽  
Late Complications ◽  
Thoracic Aortic Injury ◽  
University Of Louisville ◽  
Long Term Follow Up ◽  
Aortic Injuries

The optimal follow-up protocol for patients undergoing thoracic endovascular aortic repair (TEVAR) for traumatic thoracic aortic injury remains unclear. The objective of this study was to assess follow-up patterns in such patients and present an approach to improve long-term follow-up in this cohort. The University of Louisville Trauma Registry was queried for patients who underwent TEVAR for traumatic thoracic aortic injuries between 2006 and 2016. Demographic, injury-specific, perioperative, and outcome measures were recorded for each patient. Follow-up evaluation and duration of follow-up were captured. Follow-up imaging was reviewed for any evidence of vascular complications. A total of 56 patients underwent TEVAR for traumatic thoracic aortic injury. Median age was 48 (range 18–86). Injury mechanism was largely blunt trauma (55 (98%)). Median injury severity score was 34 (range 17–43). Median length of stay was 12.5 days (range 1–40 days), and 51 patients (91%) survived to discharge. Of these, 30 (54%) made at least one follow-up appointment, and 21 of those 30 (70%) received a follow-up CT scan. Median time to last follow-up was one month (range 0–48 months), with 12 patients (21%) having follow-up beyond two months. No patients demonstrated any evidence of vascular complications on imaging at last follow-up. Despite the increased use of TEVAR to treat traumatic aortic injuries, limited follow-up data exist to predict the long-term outcomes of such interventions. Development of statewide or regional databases may help better track outcomes and identify late complications.

scholarly journals Endovascular treatment of an iatrogenic thoracic aortic injury after spinal instrumentation: case report

2004 ◽  
Vol 39 (4) ◽  
pp. 893-896 ◽  
Author(s):  
Michael E Minor ◽  
Nicholas J Morrissey ◽  
Richard Peress ◽  
Alfio Carroccio ◽  
Sharif Ellozy ◽  
...  
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Spinal Instrumentation ◽  
Aortic Injury ◽  
Thoracic Aortic Injury

scholarly journals Endovascular repair of thoracic aortic injury after spinal instrumentation

2015 ◽  
Vol 1 (4) ◽  
pp. 264-267 ◽  
Author(s):  
Paul Claiborne ◽  
Alexandros Mallios ◽  
Kevin Taubman ◽  
John Blebea
Keyword(s):  
Endovascular Repair ◽  
Spinal Instrumentation ◽  
Aortic Injury ◽  
Thoracic Aortic Injury

Blunt Thoracic Aortic Injury and Contemporary Management Strategy

Angiology ◽  
2022 ◽  
pp. 000331972110521
Author(s):  
Ranjan Dahal ◽  
Yogesh Acharya ◽  
Alan H. Tyroch ◽  
Debabrata Mukherjee
Keyword(s):  
Motor Vehicle ◽  
Management Strategies ◽  
Aortic Injury ◽  
Medical Attention ◽  
High Morbidity ◽  
Thoracic Aortic Injury ◽  
Aortic Injuries ◽  
Diagnostic Modalities ◽  
Contemporary Management ◽  
Enhanced Computed Tomography

Thoracic aortic injury (TAI) is a leading cause of death in blunt chest trauma. Motor vehicle collisions are the commonest cause, and most patients die before receiving medical attention. Survivors who make it to the hospital also typically have other debilitating injuries with high morbidity. It is imperative to understand the nature of these injuries and implement current management strategies to improve patient outcomes. A literature review on contemporary management strategies on blunt thoracic aortic injuries was performed to evaluate the available evidence using online databases (PubMed and Google Scholar). We found that there has been an improved survival owing to the current advancement in diagnostic modalities, the use of contrast-enhanced computed tomography angiography, and contemporary management techniques with an endovascular approach. However, careful assessment of patients and a multidisciplinary effort are necessary to establish an accurate diagnosis. Minimal aortic injuries (intimal tear and aortic hematoma) can be managed medically with careful monitoring of disease progression with imaging. Endovascular approaches and delayed intervention are key strategies for optimal management of high-grade TAI.

Unusual Management of Thoracic Aortic Injury After Spinal Instrumentation: Just Glue It!

Aorta ◽  
2016 ◽  
Vol 4 (3) ◽  
Author(s):  
Yannick Deswysen ◽  
Jason Labeau ◽  
Ludovik Kaminski ◽  
Parla Astarci
Keyword(s):  
Spinal Instrumentation ◽  
Aortic Injury ◽  
Thoracic Aortic Injury

scholarly journals Pictorial review on the endovascular management of paediatric aortic injuries

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.

scholarly journals Unusual Management of Thoracic Aortic Injury After Spinal Instrumentation: Just Glue It!

Aorta ◽  
2016 ◽  
Vol 04 (03) ◽  
pp. 95-98 ◽  
Author(s):  
Yannick Deswysen ◽  
Jason Labeau ◽  
Ludovik Kaminski ◽  
Parla Astarci
Keyword(s):  
Surgical Management ◽  
Spinal Surgery ◽  
Spinal Instrumentation ◽  
Aortic Injury ◽  
Thoracic Aortic Injury ◽  
Biological Glue ◽  
Screw Misplacement

AbstractWe report the cases of two patients who presented with screw misplacement following spinal surgery. Both benefited from unusual vascular surgical management with removal of the material and injection of biological glue facing the injury, with uneventful postoperative courses.

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