title: Trend of management of traumatic thoracic aortic injuries in a single center.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, Royal Perth Hospital, Perth, Australia.
authors.forename: Bibombe P
authors.initials: BP
authors.lastname: Mwipatayi
authors.forename: Arwen
authors.initials: A
authors.lastname: Boyle
authors.forename: Michael
authors.initials: M
authors.lastname: Collin
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Papineau
authors.forename: Vikram
authors.initials: V
authors.lastname: Vijayan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001027:Aortography / Q000639:trends; D001807:Blood Vessel Prosthesis / Q000639:trends; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000639:trends*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design / Q000639:trends; D012189:Retrospective Studies; D015607:Stents / Q000639:trends; D013898:Thoracic Injuries / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000639:trends; D014193:Trauma Centers / Q000639:trends*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000639:trends*; D057772:Vascular System Injuries / Q000175:diagnosis / Q000628:therapy*; D014904:Western Australia; D055815:Young Adult
keywords: blunt thoracic aortic injury; endoleak; paraplegia; stent-graft; thoracotomy