Blood Vessel Injury
Review of a 10-year single center experience in treatment of thoracoabdominal aortic trauma
Lei Xu, Hua Zhou, Xing Jin, Xuejun Wu, Shiyi Zhang, Zhenyue Chong, Dianning Dong, Hai Yuan
Published 2015-02-15
Cite as Chin J Trauma, 2015, 31(2): 135-138. DOI: 10.3760/cma.j.issn.1001-8050.2015.02.011
Abstract
ObjectiveTo review the case data and treatment methods in a single center so as to search for rational treatments for thoracoabdominal aortic trauma.
MethodsThis retrospective analysis was performed for 34 cases (28 males and 6 females) sustaining thoracoabdominal aortic trauma treated from October 2002 to February 2013. The mean age was 41 years (range, 11-60 years). Causes of injury included traffic crashes in 14 cases, high falls in 7, stab wound in 3, abdominal crash injury in 3, aorticoesophageal fistula caused by a fish bone in 3, interventional therapy-induced aortic dissection in 2, abdominal aortic injury caused by the dropped ventricular septal defect occluder in 1, and accidental aortic injury in spinal operation in 1. There were 23 cases of thoracic aortic trauma (6 sharp and 17 blunt) and 11 cases of abdominal aortic trauma (4 sharp and 7 blunt). Preoperative imaging findings, treatment methods and follow-up data were studied.
ResultsPersonal treatment was produced based on the mechanism of injury and imaging findings. Of sharp thoracic aortic trauma, 2 cases were treated non-operatively but both died, and four cases had endovascular repair (one progressed, two cured, and one died). All the four cases of sharp abdominal aortic trauma had open surgery (three cured and one severely complicated). Of thoracic aortic trauma, four cases were treated non-operatively (three cured and one died), twelve cases had endovascular repair (11 cured and one died), and one case had open surgery and cured. Six cases of blunt abdominal aortic trauma were treated non-operatively and one had open surgery.
ConclusionsTreatment of aortic trauma should be based on injury condition, injury site, and occurrence of aortic rupture or impending of aortic rupture. Endovascular repair has a high success rate and good clinical outcome in treatment of thoracoabdominal aortic trauma.
Key words:
Aorta; Wounds and injures; Endovascular repair
Contributor Information
Lei Xu
Department of Vascular Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
Hua Zhou
Xing Jin
Xuejun Wu
Shiyi Zhang
Zhenyue Chong
Dianning Dong
Hai Yuan