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Traumatic aortic injury

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https://www.readbyqxmd.com/read/29739656/hip-dislocations-and-concurrent-injuries-in-motor-vehicle-collisions
#1
Joseph Cooper, Justin Tilan, Alexis D Rounds, Santano Rosario, Kenji Inaba, Geoffrey S Marecek
INTRODUCTION: Motor Vehicle Collisions (MVC) can cause high energy hip dislocations associated with serious injury profiles impacting triage. Changes in safety and regulation of restraint devices have likely lowered serious injuries from what was previously reported in the 1990s. This study aims to describe modern-day injury profile of patients with traumatic hip dislocations, with special attention to aortic injury. METHODS: Retrospective review of a prospectively maintained trauma database at an urban level 1 trauma center was conducted...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29725818/thoracic-trauma-in-fatal-falls-from-height-traumatic-pneumopericardium-correlates-with-height-of-fall-and-severe-injury
#2
Jakob Heimer, Dominic Gascho, Michael J Thali, Wolf Schweitzer
Pneumopericardium (PPC) describes the collection of gas in the pericardial sac. In tension Pneumopericardium (tPPC), this collection of gas may lead to cardiac tamponade. PPC following blunt trauma is considered a rare finding, as reflected by the low number of case reports on the topic. We analyzed the prevalence and pathophysiology of PPC and the associated trauma in 44 cases of falls from height. We retrospectively analyzed postmortem CT data and autopsy reports of fatal falls in the period March 2014-2017...
May 3, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29709584/resuscitative-endovascular-balloon-occlusion-of-the-aorta-implementation-and-preliminary-results-at-an-academic-level-i-trauma-center
#3
Marcus D Darrabie, Chasen A Croft, Scott C Brakenridge, Alicia M Mohr, Martin A Rosenthal, Frederick A Moore, R Stephen Smith
BACKGROUND: REBOA is a novel method of controlling subdiaphragmatic hemorrhage while improving hemodynamic stability. This procedure achieves many of the goals of resuscitative thoracotomy (RT), but is less invasive. Herein, we present the initial experience with REBOA at a level 1 academic trauma center. STUDY DESIGN: A retrospective review was performed. Orientation of surgeons and residents to REBOA was accomplished by an educational program including a hands-on simulation session (1...
April 11, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29685373/resuscitative-endovascular-balloon-occlusion-of-the-aorta-improves-cardiac-compression-fraction-versus-resuscitative-thoracotomy-in-patients-in-traumatic-arrest
#4
William Teeter, Anna Romagnoli, Philip Wasicek, Peter Hu, Shiming Yang, Deborah Stein, Thomas Scalea, Megan Brenner
STUDY OBJECTIVE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is emerging as an alternative to resuscitative thoracotomy for proximal aortic control in select patients with exsanguinating hemorrhage below the diaphragm. The purpose of this study is to compare interruptions in closed chest compression or open chest cardiac massage during REBOA versus resuscitative thoracotomy. METHODS: From May 2014 to December 2016, patients in arrest who received aortic occlusion with REBOA or resuscitative thoracotomy were included...
April 20, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29683463/a-closed-chest-model-to-induce-transverse-aortic-constriction-in-mice
#5
Lars Eichhorn, Christina Katharina Weisheit, Christopher Gestrich, Konrad Peukert, Georg Daniel Duerr, Muhammad Ajmal Ayub, Felix Erdfelder, Florian Stöckigt
Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from...
April 5, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29682123/a-case-of-traumatic-retrograde-type-a-aortic-dissection-accompanied-by-multiorgan-injuries
#6
Katsuaki Tsukioka, Tetsuya Kono, Kohei Takahashi, Hiromu Kehara, Shuichi Urashita, Kazunori Komatsu
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29678197/resuscitative-endovascular-balloon-occlusion-of-the-aorta-performed-by-emergency-physicians-for-traumatic-hemorrhagic-shock-a-case-series-from-japanese-emergency-rooms
#7
Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial. METHODS: This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017...
April 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29663146/thoraco-lumbar-fractures-with-blunt-traumatic-aortic-injury-in-adult-patients-correlations-and-management
#8
Giorgio Santoro, Alessandro Ramieri, Vito Chiarella, Massimo Vigliotta, Maurizio Domenicucci
PURPOSE: Traumatic thoraco-lumbar spine fracture spine with a concomitant blunt aortic injury is uncommon but potentially a fatal association. Our aim was to clarify: morphology of spinal fractures related to vascular damages and vice versa, diagnostic procedures and decision-making process for the best treatment options for spine and vessels. METHODS: We enrolled 42 cases culled from the literature and five personal ones, reviewing in detail by AO Spine Classification, Society of Vascular Surgery classification and Abbreviated Injury Scale for neurological evaluation...
April 16, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29661286/comparison-of-zone-3-resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-abdominal-aortic-and-junctional-tourniquet-in-a-model-of-junctional-hemorrhage-in-swine
#9
Jason M Rall, Theodore T Redman, Elliot M Ross, Jonathan J Morrison, Joseph K Maddry
BACKGROUND: Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field; however, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and the Abdominal Aortic and Junctional Tourniquet (AAJT) constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. METHODS: Yorkshire swine (n = 10, 70-90 kg) underwent general anesthesia, instrumentation, and surgical isolation of the femoral artery...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29659806/evolution-of-conservative-treatment-of-acute-traumatic-aortic-injuries-lights-and-shadows
#10
Victor X Mosquera, Miguel González-Barbeito, Milagros Marini, Daniel Gulias-Soidan, Daniel Fraga-Manteiga, Carlos Velasco, José M Herrera-Noreña, José Cuenca-Castillo
OBJECTIVES: The objective of this study is to compare early and long-term results in terms of survival and aortic complications for traumatic aortic injuries depending on the initial management strategy. METHODS: From January 1980 to January 2017, 101 patients with aortic injuries were divided into 3 groups according to management strategy at admission: 60 patients, conservative management; 26 patients, open surgery and 15 patients, endovascular repair. The groups were similar in terms of gender and trauma severity scores...
April 11, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29644869/pearls-and-pitfalls-in-imaging-of-blunt-traumatic-thoracic-aortic-injury-a-pictorial-review
#11
Neeral R Patel, Elizabeth Dick, Nicola Batrick, Michael Jenkins, Elika Kashef
Blunt thoracic aortic injury (TAI) occurs most frequently as a sequelae of high impact deceleration such as high velocity road traffic accidents and falls from height. The burden of mortality and morbidity is high, however advances in pre-hospital care, diagnostic imaging and endovascular therapies have improved outcomes in this group of patients. Emergent treatment depends on accurate, early diagnosis by the radiologist. It is therefore of paramount importance that radiologists are familiar with both the direct (intimal flap, pseudoaneurysm, aortic contour irregularity and contrast extravasation) and indirect (periaortic haematoma) imaging findings of TAI...
April 12, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29611823/blunt-traumatic-injury-to-the-aortic-root-and-aortic-valve
#12
Michael Mazzeffi, Erik Strauss, Joseph Rabin, Bartley Griffith
No abstract text is available yet for this article.
February 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29576007/the-evaluation-of-aortic-diameter-changes-during-long-term-follow-up-after-endovascular-treatment-of-acute-blunt-traumatic-thoracic-aortic-injuries
#13
Federico Fontana, Edoardo Macchi, Filippo Piacentino, Larissa Nocchi Cardim, Giuseppe De Marchi, Fabiane Barbosa, Gabriele Piffaretti, Raffaele Novario, Antonio Gaetano Rampoldi, Carlo Fugazzola
PURPOSE: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). MATERIALS AND METHODS: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29569149/-aortic-diseases-modern-diagnostic-and-therapeutic-strategies
#14
R Erbel
Aortic diseases include not only the thoracic but also the abdominal part of the aorta. In the etiology cardiovascular risk factors, such as hypertension, smoking and hyperlipoproteinemia play a major role, but more and more genetic diseases with familiar predisposition are being identified. Even large aneurysms remain asymptomatic as long as other organs in the neighborhood are not damaged and no acute aortic event occurs including aortic dissection, intramural hematoma, penetrating aortic ulcer, and traumatic aortic injury...
March 22, 2018: Herz
https://www.readbyqxmd.com/read/29547998/damage-control-resuscitation-supplemented-with-vasopressin-in-a-severe-polytrauma-model-with-traumatic-brain-injury-and-uncontrolled-internal-hemorrhage
#15
J Michael Dickson, Xu Wang, Alexander E St John, Esther B Lim, Susan A Stern, Nathan J White
Introduction: Traumatic brain injury (TBI) and hemorrhagic shock (HS) are the leading causes of traumatic death worldwide and particularly on the battlefield. They are especially challenging when present simultaneously (polytrauma), and clear blood pressure end points during fluid resuscitation are not well described for this situation. The goal of this study is to evaluate for any benefit of increasing blood pressure using a vasopressor on brain blood flow during initial fluid resuscitation in a swine polytrauma model...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29546455/successful-treatment-using-a-kissing-stent-for-blunt-abdominal-aortic-injury-a-case-report
#16
Up Huh, Chung Won Lee, Seon Hee Kim, Chan Ik Park, Sung Woon Chung, Seunghwan Song, Chang Won Kim
Blunt abdominal aortic injury (BAAI) is extremely rare. Three known treatments of BAAI exist: medical treatment, conventional surgical treatment, and endovascular treatment. Outcomes of medical and conventional surgical treatments, such as bypass graft, thrombectomy, and intimal suture, were not satisfactory. A 47-year-old man presented with multiple injuries after a high-speed vehicular accident. He was diagnosed with the traumatic aortic injury to be an intra-mural hematoma in the bifurcation of the terminal aorta...
March 15, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29501896/lumbar-arterial-bleeding-treated-with-endovascular-aneurysm-repair-a-report-of-4-patients
#17
Jun Kawachi, Naoko Isogai, Rai Shimoyama, Katsunori Miyake, Ryuta Fukai, Hiroyuki Kashiwagi, Takaaki Murata, Tomoki Nishida, Hidehiko Nakano, Hidemitsu Ogino
BACKGROUND: Lumbar arterial bleeding is a severe condition. Surgical exploration is not indicated because of its rich collateral flow. Transarterial embolization (TAE) is reportedly effective, but there have been cases of failure. It may be a time-consuming procedure for patients with multiple bleeding sources or those with poor vital signs. In this case series, we used endovascular aneurysm repair (EVAR) instead of TAE. METHOD: In this case series, we described 4 male patients (2 with traumatic injury, 1 with iatrogenic injury, and 1 with drug-induced hypocoagulability) with lumbar arterial bleeding...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29492608/traumatic-abdominal-aortic-injury-clinical-considerations-for-the-diagnostic-radiologist
#18
Richard Tsai, Demetrios Raptis, Constantine Raptis, Vincent M Mellnick
Traumatic abdominal aortic injury (TAAI) is a severe complication of penetrating and blunt trauma with significant morbidity and mortality, particularly if diagnosis is delayed. In patients with life-threatening injuries, accurate and prompt diagnosis of TAAI can be made with computed tomography (CT). Once the diagnosis of TAAI is made, the radiologist should provide an accurate description of the aortic lesion and the extent of injury in order to guide management whether it be non-operative, open aortic repair, or endoluminal stent repair...
May 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29481934/differences-in-aortic-diameter-measurements-with-intravascular-ultrasound-and-computed-tomography-after-blunt-traumatic-aortic-injury
#19
Maria Ceja-Rodriguez, Augustus Realyvasquez, Joseph Galante, William C Pevec, Misty Humphries
BACKGROUND: Intravascular ultrasound (IVUS) has been recommended as an adjunct to thoracic endovascular aortic repair (TEVAR) as computed tomography (CT) in injured patients may inaccurately determine the true aortic diameter. We hypothesize that CT and IVUS offer discordant measurements of aortic diameter in trauma patients and that each modality may result in different graft size estimates for TEVAR. METHODS: Patients treated by TEVAR for blunt aortic injury from June 2011 to 2016 were reviewed...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29455010/long-term-outcomes-of-thoracic-endovascular-aortic-repair-focused-on-bird-beak-and-oversizing-in-blunt-traumatic-thoracic-aortic-injury
#20
Marvin Ernesto García Reyes, Gabriela Gonçalves Martins, Valentín Fernández Valenzuela, José Manuel Domínguez González, Jordi Maeso Lebrun, Sergi Bellmunt Montoya
BACKGROUND: The acute aortic arch angle and narrow aortic diameter in young patients may lead to bird-beak configuration and excessive oversizing of the stent graft in thoracic endovascular aortic repair (TEVAR) for blunt traumatic thoracic aortic injury (BTTAI). Little is known about the association of these factors and complications in long-term follow-up. We evaluated the long-term outcomes in terms of complications, reinterventions, and survival, focusing on the effects of bird-beak configuration and oversizing...
February 15, 2018: Annals of Vascular Surgery
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