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https://www.readbyqxmd.com/read/29659806/evolution-of-conservative-treatment-of-acute-traumatic-aortic-injuries-lights-and-shadows
#1
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
#2
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/29644269/blunt-traumatic-celiac-artery-avulsion-managed-with-celiac-artery-ligation-and-open-aorto-celiac-bypass
#3
Matthew D Kronick, Andrew R Doben, Marvin E Morris, Ronald I Gross, Amanda Kravetz, Jeffry T Nahmias
Traumatic celiac artery injuries are rare and highly lethal with reported mortality rates of 38-62%. The vast majority are caused by penetrating trauma with only 11 reported cases due to blunt trauma (Graham et al., 1978; Asensio et al., 2000, 2002). Only 3 of these cases were complete celiac artery avulsions. Management options described depend upon the type of injury and have included medical therapy with anti-platelet agents or anti-coagulants, endovascular stenting, and open ligation. We report a case of a survivor of complete celiac artery avulsion from blunt trauma managed by open bypass...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29606678/resuscitative-endovascular-balloon-occlusion-of-the-aorta-a-bridge-to-flight-survival
#4
Carl Goforth, Matthew Bradley, Benilani Pineda, Suzanne See, Jason Pasley
Trauma endures as the leading cause of death worldwide, and most deaths occur in the first 24 hours after initial injury as a result of hemorrhage. Historically, about 90% of battlefield deaths occur before the injured person arrives at a theater hospital, and most are due to noncompressible hemorrhage of the torso. Resuscitative endovascular balloon occlusion of the aorta is an evolving technique to quickly place a balloon into the thoracic or abdominal aorta to efficiently block blood flow to distal circulation...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29595665/saddle-embolism-treated-by-thrombolysis-and-thrombus-aspiration-via-bilateral-femoral-artery-puncture-catheter-a-case-report
#5
Jie Min, Guangqiang Zhang
INTRODUCTION: Abdominal aortic saddle embolism is a rare and severe disease with the manifestation of abrupt onset, rapid progression and high mortality. Endovascular therapy becomes a new option for this disease due to its minor trauma, less complications, no requirement for general anesthesia or abdominal incisions, and shorter hospitalization duration. METHODS: A 50-year-old female was diagnosed as abdominal aortic saddle embolism, and thrombus aspiration was given immediately via bilateral femoral artery puncture catheter along with artery indwelling catheter thrombolysis...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29594359/-vascular-surgical-training-concept-for-military-surgeons-in-germany
#6
REVIEW
M Engelhardt, K Elias, B Friemert, K Klemm, C Willy
BACKGROUND: Due to the increasing threat of terrorist attacks and assassinations even in Europe, the interest in management of severe vascular injuries, which, with an increased incidence of 10% are to be expected with such penetrating wounds, is also growing; however, with increasing subspecialization in surgery there is a threat that the know-how in vascular surgery will become lost among non-vascular surgical specialists. Therefore, the Germany military established an educational program, the so-called DUOplus concept, to ensure that future military surgeons acquire and retain the experience and skills to fulfill the demanding role of a deployed surgeon...
March 28, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29590238/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-an-updated-review
#7
Marcelo Augusto Fontenelle Ribeiro Júnior, Megan Brenner, Alexander T M Nguyen, Célia Y D Feng, Raíssa Reis DE-Moura, Vinicius C Rodrigues, Renata L Prado
In a current scenario where trauma injury and its consequences account for 9% of the worlds causes of death, the management of non-compressible torso hemorrhage can be problematic. With the improvement of medicine, the approach of these patients must be accurate and immediate so that the consequences may be minimal. Therefore, aiming the ideal method, studies have led to the development of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). This procedure has been used at select trauma centers as a resuscitative adjunct for trauma patients with non-compressible torso hemorrhage...
March 26, 2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29583119/management-of-intra-abdominal-vascular-injury-in-trauma-laparotomy-a-south-african-experience
#8
Ross Weale, Victor Kong, Vassil Manchev, Wanda Bekker, George Oosthuizen, Petra Brysiewicz, Grant Laing, John Bruce, Damian Clarke
BACKGROUND: Intra-abdominal vascular injury (IAVI) is uncommon but continues to be associated with high mortality rates despite technological advances in the past decades. In light of these ongoing developments, we reviewed our contemporary experience with IAVI in an attempt to clarify and refine our management strategies and the outcome of these patients. METHODS: We retrospectively reviewed the charts of all patients admitted between January 2011 and December 2014 at a major trauma centre in South Africa who were found to have an IAVI during laparotomy for trauma...
April 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29572730/could-resuscitative-endovascular-balloon-occlusion-of-the-aorta-improve-survival-among-severely-injured-patients-with-post-intubation-hypotension
#9
REVIEW
Ramiro Manzano-Nunez, Juan Pablo Herrera-Escobar, Joseph DuBose, Tal Hörer, Samuel Galvagno, Claudia Patricia Orlas, Michael W Parra, Federico Coccolini, Massimo Sartelli, Juan Camilo Falla-Martinez, Alberto Federico García, Julian Chica, Maria Paula Naranjo, Alvaro Ignacio Sanchez, Camilo Jose Salazar, Luis Eduardo Calderón-Tapia, Valeria Lopez-Castilla, Paula Ferrada, Ernest E Moore, Carlos A Ordonez
Current literature shows the association of post-intubation hypotension and increased odds of mortality in critically ill non-trauma and trauma populations. However, there is a lack of research on potential interventions that can prevent or ameliorate the consequences of endotracheal intubation and thus improve the prognosis of trauma patients with post-intubation hypotension. This review paper hypothesizes that the deployment of REBOA among trauma patients with PIH, by its physiologic effects, will reduce the odds of mortality in this population...
March 23, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29557586/flexible-robotic-catheters-in-the-visceral-segment-of-the-aorta-advantages-and-limitations
#10
Mimi M Li, Mohamad S Hamady, Colin D Bicknell, Celia V Riga
Flexible robotic catheters are an emerging technology which provide an elegant solution to the challenges of conventional endovascular intervention. Originally developed for interventional cardiology and electrophysiology procedures, remotely steerable robotic catheters such as the Magellan system enable greater precision and enhanced stability during target vessel navigation. These technical advantages facilitate improved treatment of disease in the arterial tree, as well as allowing execution of otherwise unfeasible procedures...
March 19, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29556589/blunt-multifocal-aortic-injury-with-abdominal-aortic-intimointimal-intussusception
#11
Richa Kalsi, Charles B Drucker, Jose H Salazar, Lauren I Luther, Jose J Diaz, Rishi Kundi
Blunt abdominal aortic injury is an infrequent occurrence after blunt trauma. The majority of these injuries result from deceleration forces sustained in motor vehicle collisions. Effects of these forces on the thoracic aorta are well described, but associated spinal compression or distraction can also lead to injury of the affixed abdominal aorta. We present a case of multifocal blunt thoracic and abdominal aortic injury with circumferential abdominal aortic dissection, resulting in aortoaortic intussusception associated with a thoracolumbar spinal injury...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29552944/endovascular-approach-for-management-of-bullet-embolization-to-the-heart
#12
Alireza Mojtahedi, Sohail Contractor, Piotr S Kisza
Bullet embolization to the right heart through the vasculature is seen infrequently in cases presenting with penetrating trauma. Patients with unstable hemodynamic status are managed operatively. For a patient with stable hemodynamic parameters, diagnostic evaluation such as computed tomography angiogram, echocardiogram, or angiography could be performed to select the best treatment option. Endovascular treatment is employed infrequently in these cases but can be a viable option for select patients. We present a case of a bullet embolus to the right ventricle treated successfully with endovascular approach and discuss the technical aspects of this approach...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29535901/mri-vessel-wall-imaging-and-treatment-of-an-aneurysm-at-the-atlanto-axial-segment-of-an-aberrant-vertebral-artery
#13
Tsang Chun On Anderson, Yeung Wan Lung Ryo, Mak Ka Fung, Lui Wai Man
We report a case of unique location of an aneurysm at the atlanto-axial extradural segment of a unilateral aberrant vertebral artery. The MRI vessel wall imaging findings and possible mechanism of aneurysm formation were discussed. A 5 mm extracranial vertebral artery aneurysm located at the interlaminar space between C1 and C2 was diagnosed in a woman presenting with occipital headache. The index vertebral artery ran an aberrant course at the V3 segment, where it entered the dura between C1 and C2 instead of the usual atlanto-occipital space...
March 2018: Neurointervention
https://www.readbyqxmd.com/read/29529538/a-rare-case-of-fusiform-celiac-artery-aneurysm-after-penetrating-trauma
#14
Abdullah Shariff, Ruby Skinner, Andrea Pakula
INTRODUCTION: Visceral artery aneurysms are an uncommon clinical problem with aneurysms of the celiac artery only making up a small percentage of all visceral artery aneurysms. The more common splenic and hepatic aneurysms are often symptomatic with pain or rupture and associated hemorrhage. PRESENTATION OF CASE: We present a case of an otherwise healthy 30 yo male with an asymptomatic, posttraumatic arterial aneurysm of the celiac artery. He initially presented to our trauma center after sustaining multiple gunshot wounds which required multiple abdominal surgeries...
February 21, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29528840/endovascular-repair-of-incidentally-found-subclavian-artery-aneurysm-a-case-report-from-an-urban-level-1-trauma-center
#15
Randall W Franz, Simon R Fraser
Subclavian artery aneurysms (SAAs) are historically rare peripheral aneurysm. However, it can be associated with serious life-threatening complications including rupture, thrombosis, and embolism. The majority of such aneurysms are found incidentally. Historically, SAA have been repaired via an open approach. Increasing case reports demonstrate successful management of SAAs with endovascular repair. The present report describes a case of incidentally discovered large proximal saccular subclavian aneurysm with suspected remote traumatic etiology with a successful endovascular repair...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29524462/endovascular-repair-of-blunt-thoracic-aortic-trauma-is-post-implant-hypertension-an-incidental-finding
#16
Konstantinos Tigkiropoulos, Fragiska Sigala, Diamantis I Tsilimigras, Demetrios Moris, Konstantinos Filis, Nikolaos Melas, Dimitrios Karamanos, Christos Kontogiannis, Ioannis Lazaridis, Nikolaos Saratzis
BACKGROUND: Blunt thoracic aortic injury (BTAI) is the second most common cause of death in trauma patients. Nowadays, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice due to lower rates of mortality, paraplegia and stroke. However, concerns have been raised whether graft implantation is related to the development of hypertension in the postoperative period. OBJECTIVES: To report short- and long-term outcomes of patients undergoing TEVAR for BTAIs at a tertiary hospital as well as investigate post-implant hypertension...
March 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29518508/ilio-iliac-arteriovenous-fistulae-an-unusual-diagnosis-with-an-even-more-unusual-clinical-presentation
#17
A Coelho, P Brandão, M Lobo, I Lojo, A Canedo
INTRODUCTION: Major pelvic Ilio-Iliac arteriovenous fistula (AVF) is an exceedingly rare diagnosis with only a few described cases in the literature, most of them related to congenital defects or trauma. In this case report, we aim to present a case of an ilio-iliac AVF with an atypical clinical presentation. CASE REPORT: The patient is a 77-year-old women, with a relevant medical history of a temporally remote hysterectomy. She developed an exuberant unilateral right leg oedema and was diagnosed with a femoro-iliac deep vein thrombosis (DVT) and started on anticoagulation and daily use of elastic compression stockings...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29516005/contemporary-strategies-in-the-management-of-civilian-abdominal-vascular-trauma
#18
REVIEW
Georgios Karaolanis, Dimitrios Moris, C Cameron McCoy, Diamantis I Tsilimigras, Sotirios Georgopoulos, Chris Bakoyiannis
The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29515707/infrarenal-abdominal-aortic-pseudoaneurysm-is-it-a-real-emergency
#19
Mafalda Massara, Roberto Prunella, Pasquale Gerardi, Antonio Lillo, Giovanni De Caridi, Raffaele Serra, Stefano Notarstefano, Giovanni Impedovo
Abdominal aortic pseudoaneurysm is a rare but life-threatening condition that occurs due to penetrating or blunt trauma. Clinical manifestations are variable, and the time interval from the initial trauma to diagnosis is variable. A prompt diagnosis and an aggressive management approach are required to avoid catastrophic complications. Possible treatment options are open surgical repair, endovascular repair, pseudoanerysmal sac thrombosis induction through direct thrombin injection, and coil embolization. Here, we present the case of a 75-year-old man affected by an infrarenal abdominal aortic pseudoaneurysm presenting with abdominal and lumbar pain for 3 days, who was successfully treated with an endograft...
December 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29508015/-resuscitative-endovascular-balloon-occlusion-of-the-aorta-option-for-incompressible-trunk-bleeding
#20
REVIEW
J Knapp, M Bernhard, T Haltmeier, D Bieler, B Hossfeld, M Kulla
Hemorrhage is the single largest cause of avoidable death in trauma patients, whereby in civil emergency medicine in Europe most life-threatening hemorrhages occur in the abdomen and the pelvis. This is one reason why endovascular balloon occlusion of the aorta (EBOA), a procedure especially established in vascular surgery, is increasingly propagated for rapid bleeding control in these patients. This review article provides a comprehensive overview of the technique, indications, contraindications and complications of resuscitative endovascular balloon occlusion of the aorta (REBOA)...
March 5, 2018: Der Anaesthesist
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