Blunt injury to the supra-aortic arteries

Prêtre, René; Chilcott, Michael; Murith, Nicolas Paul Henri; Panos, Aristotelis

doi:10.1002/bjs.1800840507

Cited by 14 publications

(11 citation statements)

References 54 publications

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“…1 Most often, as in this case, an abrupt deceleration causes hyperextension of the neck, rotation of the head, and/or chest compression, leading to increased intramediastinal pressure in the vicinity of the bone structures (the sternoclavicular joint and the vertebral column), which contribute to great tension on the proximal IA. 9,10 Various lesions may form, including intimal tear, pseudoaneurysm or avulsion. An autopsy study 11 estimates that 94.5% of the victims with blunt chest trauma involving the aortic or aortic arch branches die before reaching the hospital.…”

Section: Discussionmentioning

confidence: 99%

Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report

Dias-Neto

Ramos

Teixeira

2018

Vasc Endovascular Surg

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Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation. The patient underwent emergent angiography, which confirmed that the IA dissection was not ruptured, but it was unclear whether there was a pseudoaneurysm at the origin of the IA or aortic arch involvement. The patient was considered for open surgery. An ascending aorta-to-IA bypass was achieved by the off-pump beating heart approach. The IA stump was carefully observed, but oversewing was not possible due to the extension of the intimal-medial lesions into the artic arch. An on-pump intervention was then required for aortic angioplasty with a pericardial patch that was reinforced by Gel Seal. The postoperative course was uneventful. The patient was discharged without any complications. Conventional surgery provides good results and should remain in the armamentarium for the treatment of traumatic lesions at the IA origin, particularly if aortic arch involvement cannot be ruled out, to ensure a truly patient-tailored approach.

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Section: Discussionmentioning

confidence: 99%

Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report

Dias-Neto

Ramos

Teixeira

2018

Vasc Endovascular Surg

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“…Abrupt deceleration causes simultaneous extension of the neck and rotation of the head, which creates great tension on the proximal innominate artery and results in proximal innominate artery injury. 9 The most common type of innominate artery injury is an intimal tear and pseudoaneurysm formation. The first successful repair of the innominate artery after blunt trauma was reported by Binet and colleagues 10 in 1962.…”

Section: Discussionmentioning

confidence: 99%

Polytrauma to right diaphragm, descending thoracic aorta, and innominate artery

Siddiqi

Sharma

Al-Sabti

2014

Asian Cardiovasc Thorac Ann

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Traumatic diaphragmatic rupture with concomitant great vessel injuries is a catastrophic and life-threatening injury group that requires immediate identification and management. It can be both diagnostically and therapeutically very challenging. We report a case of combined traumatic diaphragmatic, aortic and innominate artery injuries, which was managed successfully. To have a fruitful outcome, management of this injury complex should preferably be staged depending on the hemodynamic stability of the patient. In a patient with traumatic diaphragmatic injuries, one should also have a high index of suspicion of associated great vessel injuries.

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“…Die Inzidenz von interventionsbedürftigen Herz-und Gefäßverletzungen wird auf etwa 14/100.000 Patientenjahre geschätzt. Nach einer Übersichtsstudie von Pretre et al [21] wurden nach einem stumpfen Thoraxtrauma eine Verletzung des Herzens in 15-20%, der Gefäße in 15-17% der Autopsien gefunden (. Tab.…”

Section: Allgemeinesunclassified