Immediate endovascular treatment of blunt aortic injury: Our therapeutic strategy

Agostinelli, Andrea; Saccani, S; Borrello, Bruno; Nicolini, Francesco; Larini, P; Gherli, Tiziano

doi:10.1016/j.jtcvs.2005.12.015

Cited by 34 publications

(24 citation statements)

References 25 publications

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“…Cardiac Cardiac injury 11 (9,10,12,17,20,26,34,40,56,84,86) 11.7 (7.3-17.0) 65.1; p < 0.01 0.46; p ¼ 0.06 Cardiac contrusion 12 (13,19,21,22,35,39,42,43,58,61,87,92) 12.1 (6.8-18.7) 84.1; p < 0.01 0.52; p ¼…”

Section: 75mentioning

confidence: 99%

Epidemiology of concomitant injuries in traumatic thoracic aortic rupture: A meta-analysis

et al. 2014

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Traumatic thoracic aortic rupture is a highly lethal injury. For those who arrive alive at the hospital, it is of utmost importance to quickly evaluate concomitant injuries and prioritize therapeutic interventions. We aimed to review the frequency of concomitant injuries in patients with thoracic aortic rupture, according to anatomic location and type of injury. A systematic literature search of six medical databases led to the identification of 90 publications; 27 categories of thoracic aortic rupture concomitant injuries were thereafter created. The respective pooled proportions and 95% confidence intervals were calculated and ranked in order of frequency. Among the 7258 patients studied, orthopedic fractures were the most frequent thoracic aortic rupture concomitant injury, amounting to a high pooled proportion of almost 70%, followed by thoracic injury in ∼50% and abdominal injury in over 40%. Pooled proportion for any type of head injury was also high (37%) pointing to the multiple-injury type of lesions among thoracic aortic rupture victims. Thoracic aortic rupture is a devastating injury, but rarely occurs as a sole traumatic entity. The recognition of concomitant thoracic, abdominal, head injuries and fractures after thoracic aortic rupture is of paramount importance. Future studies should focus on the impact of these injuries upon survival, morbidity and disability of multiple-injured thoracic aortic rupture patients.

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Section: 75mentioning

confidence: 99%

Epidemiology of concomitant injuries in traumatic thoracic aortic rupture: A meta-analysis

et al. 2014

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“…Todos los trabajos revisados concluyen que este tratamiento es tan eficaz como la cirugía abierta 4,5,14,15 . Esta técnica permite evitar las complicaciones asociadas a la anticoagulación con heparina en pacientes con hemorragia intraparenquimatosa.…”

Section: Discussionunclassified

“…Algunos autores realizan la colocación de la endoprótesis bajo anticoagulación con heparina 4,14 . A nuestros pacientes no se les realizó dicho tratamiento por riesgo de sangrado.…”

Section: Discussionunclassified

“…No está aclarado el momento de realizar la intervención 5,14 . Una opción terapéutica es la reparación de forma diferida, priorizando las lesiones asociadas en caso de que supongan una amenaza vital para el paciente 16,17 .…”

Section: Discussionunclassified

“…La intervención se podría realizar hasta 7 meses después del traumatismo 5 . Otros autores apoyan el tratamiento inmediato endovascular para un manejo más seguro 14 . Los pacientes intervenidos dentro de las primeras 36 horas y el intervenido a los 28 días evolucionaron bien posteriormente.…”

Section: Discussionunclassified

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Manejo del traumatismo de aorta torácica en cinco pacientes politraumatizados

et al. 2008

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El traumatismo de aorta torácica es una lesión asociada a una alta morbimortalidad en el lugar del accidente. En los años noventa se generalizó el tratamiento mediante la colocación de un stent endovascular con buenos resultados. En este trabajo presentamos una serie de cinco casos clíni-cos de pacientes ingresados en la Unidad de Cuidados Intensivos de nuestro hospital durante el año 2006. De un total de 619 pacientes ingresados en el mismo periodo, 121 (19,5%) fueron traumá-ticos y 5 (4,13%) sufrían traumatismos de aorta torácica. Todos los pacientes fueron diagnosticados por tomografía computarizada helicoidal torácica al ingreso. Cuatro pacientes tenían un pseudoaneurisma de aorta y fueron intervenidos. Tres recibieron tratamiento endovascular dentro de las 36 primeras horas y el otro al vigesimoctavo día del ingreso. El quinto paciente presentó una lesión de la íntima y no se intervino. La evolución posterior fue buena en todos los casos.PALABRAS CLAVE: traumatismo de aorta torácica, tratamiento endovascular, politraumatismo. MANAGEMENT OF THORACIC AORTA TRAUMATISM IN 5 MULTIPLE TRAUMATIZED PATIENTSThoracic aorta traumatism is a lesion associated to high morbidity-mortality at the site of the accident. In the 90's, treatment by placement of an endovascular stent was generalized with good results. In this work, we present a series of 5 clinical cases of patients admitted to the Intensive Care Unit of our hospital during the year 2006. Out of a total of 619 patients admitted in the same period, 121 (19.5%) were traumatic and 5 (4.13%) had thoracic aorta traumatisms. All of the patients were diagnosed by thoracic helical computed tomography on admission. Four patients had a pseudoaneurism of the aorta and underwent an operation. Three received endovascular treatment within the first 36 hours and the fourth on day 28 of admission. The fifth patient had a lesion of the intima and was not operated on. Posterior evolution was good in all the cases. KEY WORDS: thoracic aorta traumatism, endovascular treatment, multiple traumatism.

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Endovascular Management of Aortic Transection in a Multiinjured Patient

Dindyal

Kyriakides²

2010

Vascular Surgery

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Immediate endovascular treatment of blunt aortic injury: Our therapeutic strategy

Abstract: Immediate stent-graft repair of posttraumatic aortic injury is a feasible and safe procedure. It allows us to minimize the surgical risks and to treat stable and unstable lesions even when associated lesions would contraindicate traditional surgical intervention.

Cited by 34 publications

References 25 publications

Epidemiology of concomitant injuries in traumatic thoracic aortic rupture: A meta-analysis

Epidemiology of concomitant injuries in traumatic thoracic aortic rupture: A meta-analysis

Manejo del traumatismo de aorta torácica en cinco pacientes politraumatizados

Endovascular Management of Aortic Transection in a Multiinjured Patient

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