[Traumatic aortic rupture and concomitant type B aortic dissection after skiing accident]. / Traumatische Aortenruptur mit begleitender Typ-B-Aortendissektion nach Skiunfall.

The occurrence of aortic dissections after deceleration trauma is commonplace but aortic injuries after blunt trauma are extremely rare complications. We report a case of an acute aortic rupture accompanied by a type B dissection after a skiing accident with blunt thoracic trauma and renal contusion. The leading symptom was the onset of hematuria 12 h later. The computed tomography (CT) angiography permitted the exact diagnosis and the patient was transferred for acute thoracic endovascular aortic repair. This regimen resulted in the patient achieving a stable condition and potentially harmful complications could be avoided.

Oscillometric measurement of ankle-brachial index in patients with suspected peripheral disease: comparison with Doppler method.

QUESTION UNDER STUDY: Purpose was to validate accuracy and reliability of automated oscillometric ankle-brachial (ABI) measurement prospectively against the current gold standard of Doppler-assisted ABI determination. METHODS: Oscillometric ABI was measured in 50 consecutive patients with peripheral arterial disease (n = 100 limbs, mean age 65 +/- 6 years, 31 men, 19 diabetics) after both high and low ABI had been determined conventionally by Doppler under standardised conditions. Correlation was assessed by linear regression and Pearson product moment correlation. Degree of inter-modality agreement was quantified by use of Bland and Altman method. RESULTS: Oscillometry was performed significantly faster than Doppler-assisted ABI (3.9 +/- 1.3 vs 11.4 +/- 3.8 minutes, P <0.001). Mean readings were 0.62 +/- 0.25, 0.70 +/- 0.22 and 0.63 +/- 0.39 for low, high and oscillometric ABI, respectively. Correlation between oscillometry and Doppler ABI was good overall (r = 0.76 for both low and high ABI) and excellent in oligo-symptomatic, non-diabetic patients (r = 0.81; 0.07 +/- 0.23); it was, however, limited in diabetic patients and in patients with critical limb ischaemia. In general, oscillometric ABI readings were slightly higher (+0.06), but linear regression analysis showed that correlation was sustained over the whole range of measurements. CONCLUSIONS: Results of automated oscillometric ABI determination correlated well with Doppler-assisted measurements and could be obtained in shorter time. Agreement was particularly high in oligo-symptomatic non-diabetic patients.