Journal of Trauma and Injury

Original Article

Management and outcomes of open and endovascular aortic repair with blunt traumatic aortic injuries in Western Australia: Amyna Jiwani, Warren D. Raymond, Fernando Picazo-Pineda, Sudhakar Rao, Kishore Sieunarine; J Trauma Inj. 2025;38(2):111-124. Published online June 30, 2025; DOI: https://doi.org/10.20408/jti.2024.0101

265 View
11 Download

Abstract PDF Supplementary Material: Purpose
Blunt traumatic aortic injuries (TAIs) require timely surgical intervention to prevent death. We described the management and outcomes of polytrauma patients with TAI after open and endovascular repair in Western Australia.
Methods
We performed a retrospective cohort study of patients with TAI admitted to the State Trauma Unit, Royal Perth Hospital from 2008 to 2018. Patient data were obtained from the Trauma Database and supplemented with chart review.
Results
Among 57 patients with TAI, 45 (78.9%) were male, with a mean age of 41 years, and were mainly involved in motor vehicle crashes (89.5%). They had a median Injury Severity Score of 34 (interquartile range [IQR], 21–45) and a median length of stay of 18 days. Concurrent injuries occurred in nearly all patients, including musculoskeletal (56 patients, 98.2%; mainly fractures, 91.2%), central nervous system (33 patients, 57.9%; mostly hemorrhage), injury to the chest cavity (46 patients, 80.7%), and abdominal organs (32 patients, 56.1%). The most common TAI grade was III (56.1%), followed by grade I (22.8%) and grade II (21.1%); all grade IV patients died before vascular consultation. TAI was managed with endovascular surgery (thoracic endovascular aortic repair, TEVAR) in 37 (64.9%, of which early TEVAR was performed in 29 [78.4%]), open surgery in 4 (7.0%), and conservative management in 16 (28.1%). Vascular procedures had a median duration of 81 minutes (IQR, 60–97 minutes). Acute vascular surgery–related complications were infrequent (5.3%), and all occurred post-TEVAR, mainly involving upper limb ischemia that required bypass or stenting within 72 hours of the index procedure. After discharge (52 patients), 3 patients were lost to follow-up regarding surgical survival, and late complications occurred in 6 of 48 vascular surgery patients (12.5%), who all underwent TEVAR.
Conclusions
TAI patients who received a vascular surgery review and were managed either conservatively or surgically showed favorable postdischarge survival rates and surgical results.. Patients with grade II or III TAI who underwent endovascular repair had favorable short- and long-term outcomes.; Summary

Case Report

Iatrogenic Delayed Aortic Injury Following a Surgical Stabilization of Flail Chest: Junepill Seok, Hyun Min Cho, Seon Hee Kim, Ho Hyun Kim; J Trauma Inj. 2018;31(3):174-176. Published online December 31, 2018; DOI: https://doi.org/10.20408/jti.2018.037

3,741 View
49 Download
1 Citations

Most of aortic injuries after blunt chest trauma usually occur at the aortic isthmus and are identified in the emergency department soon after arrival. Delayed aortic injures by fractured posterior ribs, however, are relatively rare and have been reported only a few times. We recently experienced an iatrogenic descending aortic injury sustained as a result of a direct puncture by a sharp rib end after surgical stabilization of rib fractures.

Summary

Citations

Citations to this article as recorded by

Surgical Stabilisation of Traumatic Rib Fractures with Chronic, Residual Type A Aortic Dissection
Kieran J. Matic, Rajkumar Cheluvappa, Selwyn Selvendran
Healthcare.2021; 9(4): 392. CrossRef

Original Articles

Management of Thoracic Aortic Injury after Blunt Trauma: Nine Cases at a Single Medical Center: Kyungwon Lee, Jae Gil Lee; J Trauma Inj. 2016;29(4):146-150. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.146

2,290 View
16 Download

Abstract PDF: PURPOSE
Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center.
METHODS
We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016.
RESULTS
The mean age was 51.1±20.8 years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications.
CONCLUSION
We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.; Summary

Clinical Analysis of TEVAR in Blunt Thoracic Aortic Injury: Gwan Woo Ku, Jin Ho Choi, Min Suk Choi, Sang Soon Park, Young Hoon Sul, Seung Je Go, Jin Bong Ye, Joong Suck Kim, Yeong Cheol Kim, Jung Joo Hwang; J Trauma Inj. 2015;28(4):232-240. Published online December 31, 2015; DOI: https://doi.org/10.20408/jti.2015.28.4.232

2,933 View
16 Download

Abstract PDF: PURPOSE
Thoracic aortic injury is a life-threatening injury that has been traditionally treated by using surgical management. Recently, thoracic endovascular aortic repair (TEVAR) has been conducted pervasively as a better alternative treatment method. Therefore, this study will focus on analyzing the outcome of TEVAR in patients suffering from a blunt thoracic aortic injury.
METHODS
Of the blunt thoracic aortic injury patients admitted to Eulji University Hospital, this research focused on the 11 patients who had received TEVAR during the period from January 2008 to April 2014.
RESULTS
Seven of the 11 patients were male. At the time of admission, the mean systolic pressure was 105.64+/-24.60 mm Hg, and the mean heart rate was 103.64+/-20.02 per minute. The median interval from arrival to repair was 7 (4, 47) hours. The mean stay in the ICU was 21.82+/-16.37 hours. In three patients, a chimney graft technique was also performed to save the left subclavian artery. In one patient, a debranching of the aortic arch vessels was performed. In two patients, the left subclavian artery was totally covered. In one patient whose proximal aortic neck length was insufficient, the landing zone was extended by using a prophylactic left subclavian artery to left common carotid artery bypass before TEVAR. There were no operative mortalities, but a patient who was covered of left subclavian artery died from ischemic brain injury. Complications such as migration, endovascular leakage, collapse, infection and thrombus did not occur.
CONCLUSION
Our short-term outcomes of TEVAR for blunt thoracic aorta injury was feasible. Left subclavian artery may be sacrificed if the proximal landing zone is short, but several methods to continue the perfusion should be considered.; Summary

Case Report

Delayed Aortic Injury Caused by a Posterior Rib Fracture: A Case Report: Chang Wan Kim, Seon Uoo Choi, Seon Hee Kim, Jae Hun Kim, Jung Joo Hwang, Hyun Min Cho, Seung Hwan Song, Jeong Su Cho; J Trauma Inj. 2015;28(1):31-33. Published online March 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.1.31

2,366 View
11 Download

Abstract PDF: Traumatic aortic injury is well recognized as a primary cause of instantaneous death in victims of thoracic blunt trauma presenting with an aortic rupture or dissection, particularly after a deceleration injury. However, a direct aortic injury caused by a fractured rib segment after blunt thoracic trauma is extremely rare. We report the case of a 43-year-old male patient who experienced an aortic injury caused by the sharp edge of a fractured rib after multiple rib fractures due to blunt thoracic trauma.; Summary

First
Prev
Page of 1
Next
Last

Search