title: Posttraumatic Resuscitation Affects Stent Graft Sizing in Patients with Blunt Thoracic Aortic Injury.
abstract: Patients with blunt aortic injury often present to the emergency department in a relatively hypovolemic state. These patients undergo extensive inhospital resuscitation. The effect of posttraumatic resuscitation on aortic diameter has implications for stent graft sizing. The potential utility of repeat aortic imaging after resuscitation remains unclear. A retrospective chart review of all adult patients presenting to a Level I trauma center between the years 2007 and 2013 was performed. Fifty-three patients were identified with a diagnosis of traumatic aortic injury. Of those, 10 had 2 CT scans before aortic repair and were selected as the study population for analysis. After resuscitation, there was a significant increase in aortic diameter both proximal and distal to the aortic injury: proximal aortic diameter increase of 1.97 mm and distal aortic diameter increase of 1.48 mm. This retrospective study shows that after resuscitation, there is a significant increase in proximal and distal aortic diameter. Interval reimaging of the thoracic aorta may be beneficial after adequate stabilization of the patient's other injuries. In certain cases, more appropriate sizing may prevent a device-related complication.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Jordan R H
authors.initials: JR
authors.lastname: Hoffman
authors.forename: Ritam
authors.initials: R
authors.lastname: Chowdhury
authors.forename: Laura S
authors.initials: LS
authors.lastname: Johnson
authors.forename: Luke P
authors.initials: LP
authors.lastname: Brewster
authors.forename: Yazan
authors.initials: Y
authors.lastname: Duwayri
authors.forename: James G
authors.initials: JG
authors.lastname: Reeves
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Veeraswamy
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Dodson
authors.forename: Ravi R
authors.initials: RR
authors.lastname: Rajani
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000293:injuries; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D016019:Survival Analysis; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014193:Trauma Centers; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*