Clinical progress in blunt aortic injury / 第二军医大学学报

Blunt aortic injury refers to damage to the aorta caused by sudden and strong force, which can be life-threatening and is not uncommon in recent years. To improve the survival of these victims remains a clinical challenge to date. This paper reviewed the pathophysiology, disease course, clinical manifestation, diagnosis and the treatment of blunt aortic injury, hoping to provide reference for a better understanding of this severe trauma and help the early diagnosis and management.

Surgical Strategy for Blunt Aortic Injury / 日本心臓血管外科学会雑誌

<b>Objective</b> : Blunt aortic injury often accompanies other organ injuries, and therefore requires an appropriate lifesaving surgical strategy. <b>Patients</b> : During the past 8 years, blunt aortic injury was reviewed, based on 5 lifesaving cases experienced in our hospital. There were 3 men and 2 women (aged 57-70, average 64.2). The Injury Severity Scores were 13-25 (an average of 17.2). <b>Intervention</b> : Regarding our strategy, stabilization of vital signs should be at first aimed by intensive primary care, concomitantly with diagnostic procedures. When stabilization of vital signs is obtained, a delayed operation would be considered after damage control resuscitation. As for 3 of these 5 cases, an emergency surgery was performed because of distinct aortic hemorrhage with instability of vital signs, and stent graft repair was applied based on anatomical indication in two cases. In the other 2 cases, primary diagnosis suggested aortic injury by the bone fracture pieces. Damage control was conducted following stabilization of vital signs, and delayed surgery was done with removal of the bone fracture pieces and repair of aortic injury, which improved activities of daily living. <b>Results</b> : All cases recovered with no particular complication, and were discharged on 9-32 days average postoperatively. <b>Conclusion</b> : Blunt aortic injury is often fatal, but the appropriate diagnosis and treatment can play an important role in obtaining the good results.

Blunt Aortic Injury: Changing the First Treatment Modality / 대한내과학회지

The incidence of blunt aortic injury is on the rise worldwise because of vehicular trauma. Historically, open repair was the only treatment of option. However, after developing of stent graft, endovascular repair has become more common and preferred treatment for aortic injury.

Debranched Thoracic Endovascular Aortic Aneurysm Repair in a Case of Blunt Aortic Injury / 日本心臓血管外科学会雑誌

A 16-year-old boy had a motorcycle accident and was given a diagnosis of blunt aortic injury (BAI) by contrast computed tomography (CT), complicated by diffuse brain injury, lung contusions and blunt liver injury. Despite conservative treatment his anemia worsened and further CT images revealed mediastinal hematoma. It was difficult to perform cardiopulmonary bypass with systemic heparinization because of his multiple injuries and therefore decided to perform endovascular stentgrafting. Aortography revealed that the proximal stent-graft landing zone to be very small, and therefore it was necessary to the cover left common carotid artery. Before stentgrafting, we performed a right subclavian artery-left common carotid artery bypass to attain a sufficient proximal landing zone, and stentgrafting was successful. We concluded that endovascular stentgrafting is an effective initial treatment for BAI complicated with multiple injuries. However, endovascular stentgrafting for BAI has some limitations because of the morphologic and anatomical characteristics of the thoracic aorta in cases of BAI. It is therefore important to perform endovascular stentgrafting for BAI on a case-by-case basis.