The Role of Surgical and Endovascular Repair of Blunt Traumatic Aortic Injury in the Modern Era: A Single-Center Experience.

Bulletin of emergency and trauma Pub Date : 2022-07-01 DOI:10.30476/BEAT.2022.94343.1335

Hamed Ghoddusi Johari, Seyed Arman Moein, Ahmad Hosseinzadeh, Javad Kojuri, Amirhossein Roshanshad, Reza Shahriarirad

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引用次数: 0

Abstract

Objective: To evaluate the efficacy of chest x-ray (CXR) in blunt traumatic aortic injury (BTAI) as a primary imaging tool in trauma patients.

Methods: We retrospectively reviewed our hospital records for blunt thoracic aortic injury patients who had a therapeutic intervention from January 2015 to February 2021. Patients' characteristics, initial chest x-rays, and computed tomography (CT) scan were extracted and re-evaluated.

Results: Eighteen patients matched the criteria of our research. The mean age and the injury severity score (ISS) was 29.8±11.2 and 38.4±14.4, respectively. Seven patients (38.9%) underwent thoracic endovascular aortic repair (TEVAR), and 11 (61.1%) had open surgery. The TEVAR group had significantly lower mean intensive care unit stay days (6.6±3.9 vs. 10.8±6.9 in open aortic repair (OAR), p<0.05). The percentile of patients requiring blood transfusion was significantly lower in the TEVAR group (57% vs. 100% in OAR, p<0.05). Mediastinal widening (66.7%) was the most common finding during the evaluation of initial chest x-rays. Interestingly, 22.2% of the initial x-rays were not remarkable for BTAI.

Conclusion: TEVAR is an advantageous choice in the management of BTAI. However, open aortic repair is the optimal decision in certain situations. It is suggested that the Interventional management of the BTAI must be performed by experienced vascular surgeons in a medical center capable of both OAR and TEVAR.

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钝性外伤性主动脉损伤的手术和血管内修复在现代的作用:单中心经验。

目的:评价胸片(CXR)作为创伤患者钝性外伤性主动脉损伤(BTAI)的主要影像学工具的疗效。方法:我们回顾性回顾了2015年1月至2021年2月接受治疗干预的钝性胸主动脉损伤患者的医院记录。提取并重新评估患者的特征、初始胸部x光片和计算机断层扫描(CT)。结果:18例患者符合我们的研究标准。平均年龄29.8±11.2，损伤严重程度评分(ISS) 38.4±14.4。7例(38.9%)行胸椎血管内主动脉修复术(TEVAR)， 11例(61.1%)行开腹手术。TEVAR组患者的平均重症监护天数(6.6±3.9 vs. 10.8±6.9)明显低于开放主动脉修复(OAR)组。结论:TEVAR是治疗BTAI的有利选择。然而，在某些情况下，主动脉切开修复是最佳选择。建议BTAI的介入治疗必须由经验丰富的血管外科医生在具有OAR和TEVAR能力的医疗中心进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bulletin of emergency and trauma

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： BEAT: Bulletin of Emergency And Trauma is an international, peer-reviewed, quarterly journal coping with original research contributing to the field of emergency medicine and trauma. BEAT is the official journal of the Trauma Research Center (TRC) of Shiraz University of Medical Sciences (SUMS), Hungarian Trauma Society (HTS) and Lusitanian Association for Trauma and Emergency Surgery (ALTEC/LATES) aiming to be a publication of international repute that serves as a medium for dissemination and exchange of scientific knowledge in the emergency medicine and trauma. The aim of BEAT is to publish original research focusing on practicing and training of emergency medicine and trauma to publish peer-reviewed articles of current international interest in the form of original articles, brief communications, reviews, case reports, clinical images, and letters.