Endovascular Stent Graft Repair of a Thoracic Aortic Gunshot Injury

Baldwin, Zachary K.; Phillips, Lornie J.; Bullard, M. Kelley; Schneider, Darren B.

doi:10.1016/j.avsg.2008.01.008

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…There is a case report of a gunshot injury to the thoracic aorta that was managed with thoracic stent graft placement. 2 There was also a recent report in an open access journal of a gunshot wound to the supraceliac aorta treated with stent graft placement; however, this case did not require coverage of any major aortic branch vessels. 4 The overall stability of this patient on presentation was probably secondary to two key factors: first, her injury was likely caused by a small-caliber weapon; and second, the injury to the supraceliac aorta was tamponaded by the diaphragmatic crus and dense surrounding connective tissue.…”

Section: Discussionmentioning

confidence: 87%

“…This use has been described for gunshot injury to the thoracic aorta as well as for iatrogenic injury. 2 , 3 The thoracoabdominal gunshot wound remains a substantial challenge that carries with it a markedly high morbidity and mortality. Novel approaches that provide rapid control of bleeding and repair of the injury in this anatomically critical region are desired.…”

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confidence: 99%

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Transaortic gunshot wound through perivisceral segment successfully managed by placement of thoracic stent graft

Feyko

Zmijewski

Lyle

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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We describe a 36-year-old woman who presented to our facility after sustaining a gunshot wound to the epigastric region. The gunshot resulted in injury to the left lobe of the liver and the twelfth thoracic vertebral body as well as in a through-and-through injury to the abdominal aorta at the level of the celiac axis. The vascular injury was managed successfully by placement of a thoracic stent graft with coverage of the celiac axis. This case demonstrates the feasibility of managing this uncommon injury with endovascular techniques.

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Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 99%

Transaortic gunshot wound through perivisceral segment successfully managed by placement of thoracic stent graft

Feyko

Zmijewski

Lyle

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…2 The majority of studies for repairs of the descending thoracic aorta with the use of a stent graft have been for aneurysmal disease. 3 However, there has been a growing body of evidence on the use of this technology in the setting of penetrating aortic trauma 4,5 as well as iatrogenic injury to the thoracic aorta secondary to pedicle screws from spine surgery, 6 puncture from an intra-aortic balloon pump, 7 bronchial artery embolization, 8 lung biopsy, 9 and central line placement. 10 We report here the first successful application of a thoracic aortic stent graft for an iatrogenic penetrating injury to the descending aorta during attempted pericardiocentesis.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Stent for Iatrogenic Penetrating Injury of the Thoracic Aorta

Vagefi

Patel

LaMuraglia

2014

Vasc Endovascular Surg

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“…Patients with these injuries have a very high mortality rate, with 90%-100% of patients dying prior to their arrival at the hospital (5,6).…”

Section: Ct Protocol For Suspected Transmediastinal Traumamentioning

confidence: 99%

Current Concepts in Imaging Evaluation of Penetrating Transmediastinal Injury

Gunn¹,

Clark²,

Sadro³

et al. 2014

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Penetrating transmediastinal injuries (TMIs) are injuries that traverse the mediastinum. These injuries are most commonly caused by firearms and knives. The investigation and management algorithms for TMI have undergone changes in recent years due to increasing evidence that computed tomography (CT) in useful in the evaluation of hemodynamically stable TMI patients. Initial investigation of TMI patients depends on the question of hemodynamic stability. In unstable patients, imaging (if any) should be limited to bedside radiography and focused ultrasonography. In hemodynamically stable patients in whom a mediastinal trajectory of injury is suspected, the primary imaging modality after radiography should be multidetector CT. CT is invaluable in the assessment of TMI due to its capacity to depict the injury track as well as demonstrate both direct and indirect signs of organ injury. On the basis of the suspected trajectory and specific findings, radiologists can play an essential role in determining future patient management and investigations for each mediastinal organ, thereby expediting appropriate investigation and treatment and avoiding unnecessary and sometimes invasive tests or surgery. The authors provide an up-to-date and evidence-based approach for the management of hemodynamically unstable and stable patients with suspected TMI, discuss management algorithms and CT protocols, and highlight common and uncommon imaging findings and diagnostic pitfalls associated with vascular, cardiac, esophageal, tracheobronchial, pleural, and pulmonary injuries. Online supplemental material is available for this article.

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Endovascular Stent Graft Repair of a Thoracic Aortic Gunshot Injury

Cited by 7 publications

References 14 publications

Transaortic gunshot wound through perivisceral segment successfully managed by placement of thoracic stent graft

Transaortic gunshot wound through perivisceral segment successfully managed by placement of thoracic stent graft

Endovascular Stent for Iatrogenic Penetrating Injury of the Thoracic Aorta

Current Concepts in Imaging Evaluation of Penetrating Transmediastinal Injury

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