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Blunt traumatic aortic injury 

Blunt traumatic aortic injury
Chapter:
Blunt traumatic aortic injury
Author(s):

Vijay M. Gadhvi

, Petrut Gogalniceanu

, and Richard Boulton

DOI:
10.1093/med/9780199658220.003.0020
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date: 18 October 2019

Blunt thoracic aortic injuries (BTAI) are the second commonest cause of trauma-associated death. The majority of injuries occur in young individuals involved in road traffic accidents and are associated with a high rate of prehospital mortality. Deceleration and thoracic compression are the main aetiological factors in the pathogenesis of BTAI, with the aortic isthmus being the most frequent site of injury. Common lesions include intimal tears, intramural haematomas, aortic dissection, and rupture resulting from non-penetrating chest trauma. Historically, BTAIs have been under-diagnosed and management outcomes with open surgery have been modest. Computed tomography is currently the first line diagnostic tool. Developments in cross-sectional imaging modalities and endovascular repair have created new opportunities and challenges in the management of this patient group. Current short-term data suggest that endovascular repair of BTAI is a viable and effective treatment modality with reduced morbidity and mortality outcomes in patients with suitable anatomy. Patients undergoing endovascular repair for BTAI need to be followed up in the medium and long terms to assess efficacy and durability of treatment.

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