Traumatic Rupture of Thoracic Aorta in Real-World Motor Vehicle Crashes

Abstract

This study emphasized four main variables influencing the TRA occurrence: ETS, compartment intrusion, age, and seat belt use. The results suggested that the injury site may be different depending on the occupant or the impact type. However, the typical TRA, i.e., a partial or complete aorta transection within the peri-isthmic region, affected any occupant independently of age and impact type. The high frequency of bilateral rib cage fractures observed in TRA victims and the significant influence of intrusion on TRA occurrence emphasized that the aortic injury mechanism mainly involves a severe direct chest impact or compression.

Vascular Trauma: New Directions in Screening, Diagnosis and Management

“…2004). Of patients surviving to evaluation TAI is present in approximately 0.3-2.8% of patients (Arthurs, et al, 2009;Bertrand, et al, 2008;Fitzharris, et al, 2004;Ungar, et al, 2006;Wintermark, et al, 2002). Detection of these few patients has long been a subject of debate.…”

“…2004). Several studies also suggest a lower threshold for imaging patients ≥ 65-70 years, and in one study for patients as young as 30 years (Bertrand, et al, 2008;Fitzharris, et al, 2004;Kaiser, et al, 2011;Smith, et al, 1995).…”

“…The result of acceleration-deceleration injuries, the most common mechanisms are falls and motor-vehicle crashes. Unfortunately the majority of patients with TAI do not reach the hospital alive, 80-90% die prior to hospital arrival, and TAI accounts for between 16-29% of motor-vehicle fatalities (Bertrand, et al, 2008;Mirvis, et al, 1987;O'Conor. 2004).…”

“…Penetrating mechanisms are responsible for the vast majority of injuries accounting for 70-95% of patients Asensio, et al, 2002;Hoyt, et al, 2001;Mattox, et al, 1989). Of blunt causes motor vehicle crashes are the most common followed by falls from height and pedestrians struck by vehicles (Asensio, et al, 2001b;Bertrand, et al, 2008;Mirvis & Shanmuganathan. 2007;Wintermark, et al, 2002).…”

“…Additionally, when the is a very high index of suspicion for TAI advanced imaging can be considered even with a normal chest x-ray. Risk factors include fall from height, high speed motor-vehicle crash particularly with a side impact, which carries a 2-fold higher risk of TAI compared to head on collision, patients with associated injuries such as traumatic brain injury, pelvic and multiple rib fractures (Bertrand, et al, 2008;Fitzharris, et al, 2004;O'Conor. 2004).…”