title: Advances in the treatment of blunt thoracic aortic injuries.
abstract: Blunt thoracic aortic injuries, even though rare in incidence, carry significant mortality rates and their management still remains challenging. There have been major shifts in diagnosing and treating these injuries in the last 5 decades, which proved to be beneficial in terms of mortality and complications. Endovascular repair has been increasingly used for definitive treatment and its outcomes appear to be at least equally safe and effective as those of open repair. We present a balanced review of the relevant literature regarding the most appropriate approach and definitive treatment of these pathological entities. Based on the studies analyzed, endovascular repair is increasingly being established as the choice of treatment, however, the conventional open surgical approach still remains a safe method for severe injuries; the mortality, complication rates and proven longterm results of the latter are continuously improving. Additionally, delayed repair, where appropriate, seems to be a safe option with very low mortality rates. Despite the encouraging short and midterm outcomes reported, endovascular treatment needs to be assessed in the longterm for more accurate conclusions to be drawn about its durability and safety.
authors.affiliation: Cardiff University School of Medicine, Heath Park Campus, University Hospital of Wales, Cardiff CF14 4XW, UK. Electronic address: dchalloumas@hotmail.co.uk.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Challoumas
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital of Wales, Heath Park Campus, Cardiff CF14 4XW, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Dimitrakakis
mesh_terms: D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality / Q000639:trends; D057510:Endovascular Procedures / Q000401:mortality; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D011446:Prospective Studies; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000150:complications / Q000401:mortality / Q000601:surgery*; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*
keywords: Blunt thoracic aortic injury; Cardiovascular surgery; Delayed repair; Endovascular repair; Open repair; Trauma