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Traumatic aortic injury

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https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#1
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28043994/long-term-results-following-emergency-stent-graft-repair-for-traumatic-rupture-of-the-aortic-isthmus%C3%A2
#2
Cecile Martin, Frederic Thony, Mathieu Rodiere, Pierre Bouzat, Pierre Lavagne, Michel Durand, Olivier Chavanon
OBJECTIVES: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. METHOD: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28034631/emergency-endovascular-management-of-acute-thoracic-aortic-pathology-a-safe-and-feasible-option
#3
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27998303/spontaneous-renal-artery-dissection-presenting-as-an-aortic-dissection-a-case-report
#4
Joshua Bucher, Ann-Jeanette Geib
BACKGROUND: Renal artery dissection is a condition that has been associated with traumatic injuries and connective tissue disorders. It has been managed in the past by multiple methods because there is no standard treatment, including vascular intervention with angioplasty and stenting, anticoagulation/antiplatelet therapy, and hypertension management. CASE PRESENTATION: We present a case of a spontaneous renal artery dissection in a 55-year-old white man with no traditional risk factors who presented twice to our emergency department in a 2-day period with different symptoms; on his first presentation he presented with symptoms consistent with renal colic and on the second visit he presented with symptoms consistent with aortic dissection...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27991022/-minimal-invasive-esophageal-resection-with-anastomosis-on-the-neck-mckeown-our-experiences-after-20-cases
#5
Elemér Mohos, Attila Nagy, György Szabados, György Réti, Tamás Kovács, Zoltán Jánó, Csaba Berki, József Mohay, Lóránt Szabó, Krisztina Bene, Gábor Bognár, Myroslav Horzov, Petra Mohos, Gábor Sándor, Gábor Tornai, Péter Szenkovits, Tibor Nagy, Csaba Orbán, Vivien Herpai
OBJECTIVE: Esophageal resection is a traumatic intervention usually performed on patients with poor condition, resulting high mortality and morbidity. To improve the high incidence of complications, minimal invasive interventions were introduced. The results of the thoracoscopically and laparoscopically performed esophageal resection (McKeown) was investigated after 20 cases and the technical details of the surgical intervention are presented. PATIENTS AND METHOD: 20 thoracoscopic esophageal resection with laparoscopic gastric tube formation (sec...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27908819/endovascular-treatment-of-a-traumatic-thoracic-aortic-injury-in-an-eight-year-old-patient-case-report-and-review-of-literature
#6
Maen Aboul Hosn, Rachael Nicholson, Joseph Turek, William J Sharp, Luigi Pascarella
Traumatic aortic injuries in children and adolescents are rare. Although endovascular repair has become the preferred approach for such injuries in adults, open repair has endured as the gold standard in children owing mainly to the smaller aortic and access vessel diameter and the scarcity of long-term follow-up data. We report a successful endovascular repair of a traumatic thoracic aortic injury in an 8-year-old girl using a Zenith Alpha thoracic endograft (Cook Medical, Bloomington, IN). We also review the literature on endovascular treatment of traumatic aortic injuries in the pediatric population...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890846/successful-hybrid-treatment-of-a-traumatic-rupture-of-the-left-primitive-carotid-artery-in-a-polytraumatized-patient-a-case-report
#7
Dorian Verscheure, Julien Gaudric, Clémence Jouhannet, Laurent Chiche, Fabien Koskas
Traumatic injury of the left common carotid is a rare but severe disease, and is an uncommon situation in emergency units. Thoracic aortic lesions are often associated with other injuries, making their treatment challenging. We report the case of a successful hybrid approach to treat this lesion using a total supra aortic vessel debranching and a thoracic endovascular graft to cover the rupture, in a 38-year-old polytraumatized patient. After aortic, abdominal, and orthopedic surgery, the patient recovered well...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890837/association-between-prehospital-time-and-mortality-following-blunt-thoracic-aortic-injuries
#8
Biniam Kidane, Vaibhav Gupta, Mostafa El-Beheiry, Kelly Vogt, Neil G Parry, Richard Malthaner, Thomas L Forbes
BACKGROUND: Blunt thoracic aortic injuries (BTAIs) can be lethal, but advances in trauma systems and surgical care have helped reduce mortality. The purpose of this study is to investigate whether time from injury to presentation is associated with mortality following BTAI. METHODS: Using the Ontario Trauma Registry, all patients were identified who were hospitalized with BTAI between 1999 and 2009. Variables including age, sex, Injury Severity Score, Charlson comorbidity index, systolic blood pressure on admission, operative intervention, and time from injury to presentation were analyzed using multivariate logistic regression to determine independent predictors of mortality...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27858166/traumatic-aortic-injury-does-the-anatomy-of-the-aortic-arch-influence-aortic-trauma-severity
#9
Jacek Wojciechowski, Lukasz Znaniecki, Kamil Bury, Kamil Chwojnicki, Jan Rogowski
PURPOSE: Traumatic aortic injury (TAI) is a rare but life-threatening type of injury. We investigate whether the anatomy of the aortic arch influences the severity of aortic injury. METHODS: This is a retrospective study of twenty-two cases treated with TEVAR for TAI in our department from 2009 to 2014. Aortic injury was assessed in accordance with the recommendations of the Society of Vascular Surgery. We measured the aortic arch angle and the aortic arch index, based on the initial angio-CT scan, in each of the analyzed cases...
November 17, 2016: Surgery Today
https://www.readbyqxmd.com/read/27849321/evaluation-of-patients-diagnosed-with-acute-blunt-aortic-injury-and-their-bedside-plain-chest-radiography-in-the-emergency-department-a-retrospective-study
#10
Funda Karbek Akarca, Tanzer Korkmaz, Celal Çınar, Elif Dilek Çakal, Murat Ersel
BACKGROUND: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury. METHODS: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27765622/guidelines-of-the-french-society-of-otorhinolaryngology-sforl-second-line-treatment-of-epistaxis-in-adults
#11
B Verillaud, L Robard, J Michel, V Pruliere Escabasse, E Béquignon, L Crampette, O Malard
OBJECTIVES: The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on second-line treatment of epistaxis in adults, after failure of anterior and/or anterior-posterior nasal packing. METHODS: A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience...
October 17, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/27763300/differences-in-aortic-diameter-measurements-with-intravascular-ultrasound-and-computed-tomography-after-blunt-traumatic-aortic-injury
#12
Maria Ceja Rodriguez, Augustus Realyvasquez, Joseph Galante, William Pevec, Misty Humphries
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27699853/atypical-echocardiographic-findings-in-traumatic-aortic-transection
#13
Neal S Gerstein, Lindsay J Jinkins, Liem C Nguyen, Timothy M Maus, Todd S Dettmer, Lev Deriy
Aortic rupture and transection are constituents of the acute aortic syndrome. Injury to the thoracic aorta during motor vehicle crashes is associated with blunt chest trauma and rapid deceleration mechanisms. Type A dissections and/or rupture of the aorta at the level of the aortic isthmus are the more common presentations of aortic injuries associated with motor vehicle crashes. We present the case of atypical echocardiographic findings of a nearly complete circumferential transection of the proximal ascending aorta injury after a motorcycle crash...
October 4, 2016: Echocardiography
https://www.readbyqxmd.com/read/27671454/outcomes-of-left-subclavian-artery-transposition-for-hybrid-aortic-arch-debranching
#14
Ludovic Canaud, Vincent Ziza, Baris Ata Ozdemir, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Pierre Alric
BACKGROUND: The aim of this study was to evaluate outcomes of left subclavian artery (LSA) revascularization for hybrid aortic arch debranching. METHODS: Between 1998 and 2015, 68 patients (41 men, mean age 67+/-16 years) underwent TEVAR with LSA coverage, 19.2% (n = 13) were never revascularized and the remaining patients underwent LSA revascularization (n = 55; 80.8%) . Revascularization was achieved by LSA-carotid transposition via a medial approach in 81.8% (n = 45) and a lateral approach in 18...
September 23, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27588036/prediction-of-blunt-traumatic-injuries-and-hospital-admission-based-on-history-and-physical-exam
#15
Alan L Beal, Mark N Ahrendt, Eric D Irwin, John W Lyng, Steven V Turner, Christopher A Beal, Matthew T Byrnes, Greg A Beilman
BACKGROUND: We evaluated the ability of experienced trauma surgeons to accurately predict specific blunt injuries, as well as patient disposition from the emergency department (ED), based only on the initial clinical evaluation and prior to any imaging studies. It would be hypothesized that experienced trauma surgeons' initial clinical evaluation is accurate for excluding life-threatening blunt injuries and for appropriate admission triage decisions. METHODS: Using only their history and physical exam, and prior to any imaging studies, three (3) experienced trauma surgeons, with a combined Level 1 trauma experience of over 50 years, predicted injuries in patients with an initial GCS (Glasgow Coma Score) of 14-15...
2016: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27568394/ct-of-suspected-thoracic-acute-aortic-injury-in-the-emergency-department-is-routine-abdominopelvic-imaging-worth-the-additional-collective-radiation-dose
#16
Shawn Haji-Momenian, Jonathan Rischall, Neil Okey, Myles Taffel, Nadia Khati, Robert Zeman
This study aimed to determine the incidence of non-traumatic acute aortic injury (AAI) extending from the chest into the abdomen or pelvis in emergency department (ED) patients with acute aortic syndrome (AAS), to estimate the effective dose of the abdominopelvic portion of these CT exams, and to compare the number needed to screen (NNS) with the collective population radiation dose of imaging those stations. All patients (n = 238) presenting to the ED with AAS between March 2014 and June 2015 who were imaged per CT AAI protocol (noncontrast and contrast-enhanced CT angiography of the chest, abdomen, and pelvis) were retrospectively identified in this IRB-approved HIPAA-compliant study...
August 27, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27522975/aortic-arch-and-thoracic-aorta-curvature-remodeling-after-thoracic-endovascular-aortic-repair
#17
Gaspar Mestres, Marvin E Garcia, Xavier Yugueros, Rodrigo Urrea, Paolo Tripodi, Fernando Gomez, Jordi Maeso, Vincent Riambau
BACKGROUND: The objective of this study was to analyze the original curvature of the aortic arch and thoracic aorta, and how it is modified after the placement of a thoracic endograft. METHODS: We retrospectively analyzed all patients primarily treated for thoracic aortic aneurysms and blunt traumatic aortic injuries by means of an endograft sealed into the aortic arch (zones, Z1-Z3) in 2 different centers (Vascular Surgery Division, Hospital Clinic, UB; and Vascular and Endovascular Surgery Department, Hospital Vall d'Hebron, UAB; Barcelona, Spain), between 2010 and 2015...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27476569/-thoracic-endovascular-aortic-aneurysm-repair-in-a-young-patient-with-descending-aortic-injury-report-of-a-case
#18
Hironari No, Satoru Nishida, Takeshi Takagi, Ryosuke Mohri
A 15-year-old boy was referred to our emergency room due to a penetrating injury of the back. Computed tomography( CT) demonstrated a descending aortic injury at the Th9/10 level, bilateral hemothorax, and spinal cord injury. Although surgical treatment was indicated, multiple organ injury complicated open surgical repair, which required cardiopulmonary bypass with full heparinization. Therefore, the patient was scheduled to undergo thoracic endovascular aortic repair (TEVAR). A 23×33-mm Excluder aortic extension cuff was chosen for the small, 15-mm diameter aorta...
August 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27422556/case-report-open-replacement-of-incomplete-semi-circular-traumatic-ruptures-of-the-ascending-and-descending-aorta
#19
Miroslawa Mytsyk, Martin T R Grapow, Jasmin Shahinian, Markus Maurer, Lorenz Gurke, Friedrich S Eckstein
An incomplete traumatic rupture of the ascending aorta is a rare but life-threatening condition. Hence, the assessment of the extent of the injury prior to therapy is crucial. We report a case of a 50-year-old male with traumatic aortic rupture who underwent emergency surgery after the evaluation of computed tomography scan (CT-scan). The surgical treatment involved replacement of the ascending aorta and stent implantation in descending aorta due to its covered rupture.
2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27317209/pseudoaneurysm-of-the-thoracic-aorta-sustained-during-exposure-to-a-tornado-diagnosed-with-ecg-synchronized-ct-aortography
#20
Amit Chakraborty, Paul F von Herrmann, Ryan E Embertson, Kevin P Landwehr, Michael A Winkler
A case of a tornado victim with a delayed presentation of injury to the aortic isthmus is discussed. Tornado forces resemble the forces of high energy explosions, and the injuries that can occur as a result of these forces can be bizarre. The patient presented with the unique computed tomography (CT) findings of isolated pseudoaneurysm of the thoracic aorta in the absence of other traumatic injury to the thorax. Equivocal results of the initial CT aortogram (CTA) were confirmed with ECG-synchronized CTA (ECG-CTA), demonstrating the superiority of ECG-CTA as compared to standard CTA...
July 2016: Clinical Imaging
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