Open vs endovascular repair of blunt traumatic thoracic aortic injuries.
A 42-year-old female is involved in a motor vehicle accident and presents with a number of injuries. She is hemodynamically stable and is found to have multiple rib fractures, a hemopneumothorax, and several uncomplicated long bone fractures. A CT scan of her chest reveals a traumatic injury to her proximal descending thoracic aorta with evidence of pseudoaneurysm formation and surrounding hematoma (Fig 1). The following debate attempts to resolve whether open repair remains the gold standard for the treatment of blunt thoracic aortic injuries.
Rheaume
Pascal
P
Division of Vascular Surgery, Vancouver General Hospital & University of British Columbia, British Columbia, Canada.
Chen
Jerry
J
Casey
Patrick
P
D000063:Accidents, Traffic; D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000601:surgery*