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Original Article
Single-Center Clinical Analysis of Traumatic Thoracic Aortic Injuries: A Retrospective Observational Study
Dae Sung Ma, Yang Bin Jeon
J Trauma Inj. 2021;34(2):81-86.   Published online June 24, 2021
DOI: https://doi.org/10.20408/jti.2021.0019
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  • 1 Citations
AbstractAbstract PDF
Purpose

This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution.

Methods

During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed.

Results

Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0–41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7).

Conclusions

Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

Summary

Citations

Citations to this article as recorded by  
  • Patterns, management options and outcome of blunt thoracic aortic injuries: a 20-year experience from a Tertiary Care Hospital
    Hassan Al-Thani, Suhail Hakim, Mohammad Asim, Kaleem Basharat, Ayman El-Menyar
    European Journal of Trauma and Emergency Surgery.2022; 48(5): 4079.     CrossRef

J Trauma Inj : Journal of Trauma and Injury