Acute traumatic aortic tear: open versus stent-graft repair.
Semin Vasc Surg
; 19(1): 48-59, 2006 Mar.
Article
en En
| MEDLINE
| ID: mdl-16533692
ABSTRACT
Acute traumatic aortic tear (ATAT) is the second most common cause of deaths in trauma patients (about 8,000 deaths/year in the USA). Due to circumferential aortic disruption, up to 90% die at the scene. Responsible trauma mechanisms are penetrating (gunshot/stab wounds), iatrogenic (interventional catheterization) and, most frequently, blunt chest trauma (high-speed motor vehicles, falls from heights, crushes, explosions) resulting in injury at the aortic isthmus region (loco typico, about 90%). Severe multiple system injuries (polytrauma), especially to intracranial and intraabdominal organs, are characteristic and prognostically predicitive. Immediate transthoracic open repair of ATAT has a mortality risk of 8% to 33% and paraplegia risk of 2% to 26%. Contrast enhanced CT scan has replaced the classical angiography as the diagnostic tool of choice. Patients with life-threatening multisystem injuries are scheduled for delayed repair after initial stabilization. Currently, the use of endovascular stent-grafts (EVAR) is being investigated. Our personal series confirms that EVAR for ATAT is a viable alternative to open repair while minimizing the morbidity and mortality of the open procedure and having a limited impact on trauma destabilization. The assessment of long-term durability of EVAR is one of the key issues to consider EVAR as the first choice of treatment.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Aorta Torácica
/
Rotura de la Aorta
/
Heridas no Penetrantes
/
Prótesis Vascular
/
Cateterismo
/
Stents
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Semin Vasc Surg
Asunto de la revista:
ANGIOLOGIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Alemania