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Traumatic aortic injury

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https://www.readbyqxmd.com/read/29143168/limited-influence-of-blunt-aortic-injuries-on-the-outcome-of-polytraumatized-patients-a-matched-pair-analysis
#1
A Omar, C Macke, M Winkelmann, E Beckmann, P Mommsen, C Schröter, C Krettek, Christian Zeckey
INTRODUCTION: Traumatic lesions of great vessels such as the aorta are life-threatening injuries. There is limited evidence about the influence of traumatic aortic injuries in multiple trauma patients in particular with regard to posttraumatic complications. The aim of this study was to evaluate the influence of blunt thoracic aortic injuries in multiple trauma patients compared to a multiple trauma cohort without this specific injury. In addition, the safety of Thoracic Endovascular Aortic Repair (TEVAR) in multiple trauma patients was analyzed...
November 15, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29127893/traumatic-fatal-aortic-rupture-in-motorcycle-drivers
#2
Guido Pelletti, Giovanni Cecchetto, Alessia Viero, Maria De Matteis, Guido Viel, Massimo Montisci
Traumatic fatal aortic rupture (FAR) is a common finding in victims of motor vehicle crashes (MVC), but its aetiology and mechanisms of production remain an issue of major concern, above all in motorcyclists. This study reports a series of cases obtained from a retrospective analysis of traumatic FARs occurring in motorcycle drivers, with the aim of defining the injury patterns and correlating them with the mechanisms of FAR production. Circumstantial, autopsy and histology data were collected through a retrospective analysis of post mortem examinations performed at the Institute of Legal Medicine of the University of Padova between 2014 and 2016...
November 6, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29124037/chylothorax-after-blunt-chest-trauma-a-case-report
#3
Pawit Sriprasit, Osaree Akaraborworn
Traumatic chylothorax after blunt chest trauma alone is considered rare. Our patient was a 27-year-old female who was in a motorcycle accident and sustained blunt thoracic and traumatic thoracic aortic injuries with T1-T2 vertebral subluxation. She underwent thoracic endovascular aortic repair from T4 to T9 without any thoracic or spinal surgery. On postoperative day 7, the drainage from her left chest turned into a milky-white fluid indicative of chyle leakage. The patient was treated conservatively for 2 weeks and then the chest drain was safely removed...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29124026/risk-factors-for-pneumonia-in-ventilated-trauma-patients-with-multiple-rib-fractures
#4
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29095270/pituitary-insufficiency-following-traumatic-thoracic-injury-in-an-adolescent-male-patient-a-case-report-and-literature-review
#5
REVIEW
Aleksandra Gilis-Januszewska, Łukasz Kluczyński, Małgorzata Wilusz, Jacek Pantofliński, Renata Turek-Jabrocka, Dorota Pach, Alicja Hubalewska-Dydejczyk
RATIONALE: Traumatic thoracic injuries in adolescents are rare but could be connected with traumatic brain injuries (TBI) and development of chronic hypopituitarism. Early recognition of these endocrine problems is a significant challenge to clinicians. We present difficulties in diagnosis of hypothalamic-pituitary insufficiency following traumatic thoracic injury in adolescence. We also review the literature of similar cases. PATIENT CONCERNS: We present a case of a 24-years-old male...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049608/acute-administration-of-oestradiol-or-progesterone-in-a-spinal-cord-ischaemia-reperfusion-model-in-rats
#6
Leonardo Pessoa Cavalcante, Sueli Gomes Ferreira, Daniel Romano Pereira, Sergio Rodrigues de Moraes, Rafael Simas, Paulina Sannomiya, Ana Cristina Breithaupt-Faloppa, Luiz Felipe Pinho Moreira
OBJECTIVES: Despite research into protective pharmacological adjuncts, paraplegia persists as a dreaded complication after thoracic and thoracoabdominal aortic interventions. Reports on gender-related neurological outcomes after ischaemic and traumatic brain injuries have led to increased interest in hormonal neuroprotective effects and have generated other studies seeking to prove the neuroprotective effects of the therapeutic administration of 17β-oestradiol and of progesterone. We hypothesised that acute administration of oestradiol or progesterone would prevent or attenuate spinal cord ischaemic injury induced by occlusion of the descending thoracic aorta...
September 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29040486/delayed-traumatic-rupture-of-the-thoracic-aorta-into-the-esophagus
#7
V A Komborozos, I Belenis, C Malagari, P Yannopoulos
A case of delayed rupture of the thoracic aorta into the esophagus after blunt thoracic injury is reported. It involved a hemodynamically stable 18-year-old male patient without any clinical or radiological signs to indicate aortic injury. Aortoesophageal fistula presented in the fifth post traumatic day, with a sudden dyspnea episode, intraperitoneal hemorrhage and lower gastrointestinal bleeding, due to intraperitoneal and intragastric rupture of intramural esophageal hematoma.
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28973104/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-proximal-aortic-control-in-patients-with-severe-hemorrhage-and-arrest
#8
Megan Brenner, William Teeter, Melanie Hoehn, Jason Pasley, Peter Hu, Shiming Yang, Anna Romagnoli, Jose Diaz, Deborah Stein, Thomas Scalea
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis, often instead of emergency department thoracotomy. The ability to perform aortic occlusion (AO) with an intravascular device allows focused occlusion at the most distal level to perfuse proximal regions while slowing hemorrhage to injured areas. Objective: To describe what is to date the largest single-institution experience with REBOA in the United States...
September 27, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28947225/determinants-and-outcomes-of-nonoperative-management-for-blunt-traumatic-aortic-injuries
#9
Harleen K Sandhu, Samuel D Leonard, Alexa Perlick, Naveed U Saqib, Charles C Miller, Kristofer M Charlton-Ouw, Hazim J Safi, Ali Azizzadeh
OBJECTIVE: The natural history and parameters for successful nonoperative management of blunt traumatic aortic injuries (BTAIs) involving the descending aorta are poorly understood. We examined our experience with nonoperative BTAI treatment (anti-impulse, blood pressure) and evaluated for determinants of successful outcomes. METHODS: We performed a review of our institutional prospective trauma registry database for all BTAI patients from 1999 to 2015. Computed tomography angiography was used to classify aortic injuries on the basis of severity: grade I, intimal tear; grade II, intramural hematoma; grade III, aortic pseudoaneurysm; and grade IV, free rupture...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28947217/management-and-evolution-of-a-wallstent-migration-in-a-pediatric-blunt-traumatic-abdominal-aortic-injury
#10
Ana Apodaka Diez, Ederi Mikelarena Monteiro, Yolanda Gallardo Hoyos, Juan Luis Fonseca Legrand
Blunt traumatic abdominal aortic injury in children is a rare but a severe condition. The clinical manifestation often involves other intra-abdominal visceral injuries and vertebral fractures. The best therapeutic management is still unclear with few reported endovascular cases treated. The following is the case of a 13-year-old male with an aortic abdominal dissection, spleen laceration, jejunal contusion, and hemoperitoneum after a motor vehicle collision. An endovascular approach was decided upon after the progression of the intimal aortic tear...
September 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28943007/thoracic-endovascular-aortic-repair-migration-and-aortic-elongation-differentiated-using-dual-reference-point-analysis
#11
Hillary B Alberta, Toshio Takayama, Annalise Panthofer, Richard P Cambria, Mark A Farber, William D Jordan, Jon S Matsumura
OBJECTIVE: We evaluated images of patients undergoing a thoracic endovascular aortic repair procedure using two reference points as a means for differentiating stent graft migration from aortic elongation. Conventional standards define migration of a stent graft as an absolute change in the distance from the distal graft ring to a distal landmark ≥10 mm compared with a baseline measurement. Aortic elongation occurs over time in both healthy individuals and patients with aortic disease...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28939111/open-descending-thoracic-or-thoracoabdominal-aortic-approaches-for-complications-of-endovascular-aortic-procedures-19-year-experience
#12
Konstantinos Spiliotopoulos, Ourania Preventza, Susan Y Green, Matt D Price, Hiruni S Amarasekara, Brittany M Davis, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
OBJECTIVES: Endovascular aortic repair is increasingly being used to treat aneurysms, dissections, and traumatic injuries, despite its unknown long-term durability. We describe our 19-year experience with open descending thoracic and thoracoabdominal aortic repair after endovascular aortic repair. METHODS: Between 1996 and 2015, 67 patients were treated with open distal arch, descending thoracic, or thoracoabdominal aortic repair, or extra-anatomic bypass repair with aortic extirpation for complications after endovascular repair of the thoracic (n = 45, 67%) or abdominal (n = 22, 33%) aorta...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28893706/hypertension-acute-stent-thrombosis-and-paraplegia-6%C3%A2-months-after-thoracic-endovascular-aortic-repair-for-blunt-thoracic-aortic-injury-in-a-22-year-old-patient
#13
Ombretta Martinelli, Federico Faccenna, Alban Malaj, Jihad Jabbour, Salvatore Venosi, Roberto Gattuso, Bruno Gossetti, Luigi Irace
Thoracic endovascular aortic repair (TEVAR) is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year-old male was admitted to the emergency department following a high-impact road traffic collision. Whole-body computed tomography (CT) scan documented multiple injuries, including rupture of descending thoracic aorta just below the isthmus. There was no evidence of paraplegia or stroke. We decided to treat him in an endovascular fashion with a Zenith Cook (Cook Incorporated, Bloomington, IN) endograft...
September 9, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28801841/the-use-of-aortic-balloon-occlusion-in-traumatic-shock-first-report-from-the-abo-trauma-registry
#14
M Sadeghi, K F Nilsson, T Larzon, A Pirouzram, A Toivola, P Skoog, K Idoguchi, Y Kon, T Ishida, Y Matsumara, J Matsumoto, V Reva, M Maszkowski, A Bersztel, E Caragounis, M Falkenberg, L Handolin, B Kessel, D Hebron, F Coccolini, L Ansaloni, J J Morrison, T M Hörer, M J Madurska
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014...
August 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28733569/a-case-of-missed-blunt-traumatic-aortic-injury-btai
#15
N M Nik Azlan, H Rossman
We are reporting a case of missed blunt traumatic aortic injury (BTAI). A 28 year male presented with chest pain following a motor vehicle accident. He was discharged following normal clinical signs and chest radiograph. The following day he complained of lower limb weakness. Traumatic aortic dissection was revealed via computer tomography (CT) of the thorax. BTAI cannot be ruled out with normal clinical signs and chest radiograph alone. CT thorax is mandatory to rule out BTAI in high impact chest injury.
June 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28719426/blunt-traumatic-injury-to-the-aortic-root-and-aortic-valve
#16
Michael Mazzeffi, Erik Strauss, Joseph Rabin, Bartley Griffith
No abstract text is available yet for this article.
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28696855/don-t-forget-the-abdominal-wall-imaging-spectrum-of-abdominal-wall-injuries-after-nonpenetrating-trauma
#17
Shanna A Matalon, Reza Askari, Jonathan D Gates, Ketan Patel, Aaron D Sodickson, Bharti Khurana
Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury)...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#18
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#19
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28647636/transcatheter-arterial-embolization-of-a-lumbar-artery-injury-with-traumatic-aortic-dissection
#20
Makoto Aoki, Hiroyuki Tokue, Kei Shibuya, Masato Murata, Shuichi Hagiwara, Kiyohiro Oshima
Whole-body-enhanced computed tomography of a septuagenarian woman hit by a truck revealed a traumatic aortic dissection (Stanford B) and arterial bleeding from the right lumbar artery in the right iliopsoas muscle. Angiography revealed an active arterial extravasation from a false lumen of the left lumbar artery. We performed a transcatheter arterial embolization (TAE) of the right lumbar artery. After fenestration of the intimal flap, the left lumbar artery was successfully selected and embolized; the patient's clinical condition subsequently stabilized...
June 22, 2017: Annals of Vascular Surgery
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