Blunt Aortic Injury - The Eastern Association for the Surgery of Trauma

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Eastern Association for the Surgery of Trauma

Blunt Aortic Injury

Long-term outcomes of thoracic endovascular aortic repair: A single institution's 11-year experience.

Brenner M, Teeter W, Hadud M, Hoehn M, O'Connor J, Stein D, Scalea T.

J Trauma Acute Care Surg. 2017 Apr;82(4):687-693.

Rationale for inclusion: Access specific and long-term outcomes were followed in trauma patients who underwent percutaneous TEVAR.

CAVEAT: Followup was limited at 62%, 25% and 14% at 1, 3 and 5 years respectively.

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An outcome analysis of endovascular versus open repair of blunt traumatic aortic injuries.

Azizzadeh A, Charlton-Ouw KM, Chen Z, Rahbar MH, Estrera AL, Amer H, Coogan SM, Safi HJ.

J Vasc Surg. 2013 Jan;57(1):108-14; discussion 115.

Rationale for inclusion: Prospective, single-center study analyzing outcomes after TEVAR and open repair of blunt aortic injuries.

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Blunt traumatic thoracic aortic injuries: early or delayed repair--results of an American Association for the Surgery of Trauma prospective study.

Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O'Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Lineen E, Margulies D, Malka V, Chan LS.

J Trauma. 2009 Apr;66(4):967-73.

Rationale for inclusion: AAST prospective multi-center study evaluating timing of aortic repair.

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Diagnosis and treatment of blunt thoracic aortic injuries: changing perspectives.

Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O'Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Lineen E, Margulies D, Malka V, Chan LS.

J Trauma. 2008 Jun;64(6):1415-8; discussion 1418-9.

Rationale for inclusion: A comparison between two AAST prospective multi-center trials revealed CT for diagnosis, delayed repair and repair with stent grafts became more common while mortality decreased.

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Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study.

Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O'Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Lineen E, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Margulies D, Malka V, Chan LS; American Association for the Surgery of Trauma Thoracic Aortic Injury Study Group.

J Trauma. 2008 Mar;64(3):561-70; discussion 570-1.

Rationale for inclusion: Endovascular stent grafts were compared to traditional operative repairs in this prospective, multi-center study. Stent grafts were associated with decreased blood transfusion and mortality.

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Prospective study of blunt aortic injury: helical CT is diagnostic and antihypertensive therapy reduces rupture.

Fabian TC, Davis KA, Gavant ML, Croce MA, Melton SM, Patton JH Jr, Haan CK, Weiman DS, Pate JW.

Ann Surg. 1998 May;227(5):666-76; discussion 676-7.

Rationale for inclusion: Prospective evaluation of helical CT for blunt aortic injury diagnosis, demonstrating 100% negative predictive value for CT and 97% for aortography.

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Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma.

Fabian TC, Richardson JD, Croce MA, Smith JS Jr, Rodman G Jr, Kearney PA, Flynn W, Ney AL, Cone JB, Luchette FA, Wisner DH, Scholten DJ, Beaver BL, Conn AK, Coscia R, Hoyt DB, Morris JA Jr, Harviel JD, Peitzman AB, Bynoe RP, Diamond DL, Wall M, Gates JD, Asensio JA, Enderson BL, et al.

J Trauma. 1997 Mar;42(3):374-80; discussion 380-3.

Rationale for inclusion: Prospective multi-center study involving 50 trauma centers and 274 blunt aortic injuries. "Clamp and sew" and aortic cross clamp times >30minutes were associated with paraplegia.

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Transesophageal echocardiography in the diagnosis of traumatic rupture of the aorta.

Smith MD, Cassidy JM, Souther S, Morris EJ, Sapin PM, Johnson SB, Kearney PA.

N Engl J Med. 1995 Feb 9;332(6):356-62.

Rationale for inclusion: Transesophageal echocardiography and aortography were sequentially performed in 101 patients with possible blunt aortic injuries. TEE was found to be highly sensitive and specific for detection of aortic injury.

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Nonpenetrating traumatic injury of the aorta.

Parmley LF, Mattingly TW, Manion WC, Jahnke EJ Jr.

Circulation. 1958 Jun;17(6):1086-101.

Rationale for inclusion: A description of 296 blunt aortic injuries which established the most common site of injury and need for prompt diagnosis.

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