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Blunt thoracic aortic injury: old problem and new technology.
L D Britt1, Matthew M Campbell
1Eastern Virginia Medical School, Department of Surgery, Norfolk, Virginia 23507-1912, USA. BrittLD@evms.edu
Journal of Long-Term Effects of Medical Implants
|December 3, 2003
Summary
Diagnostic and therapeutic options for transmural aortic injuries have advanced. While aortography remains the gold standard, contrast-enhanced spiral thoracic computed tomography is a promising alternative for diagnosing these life-threatening conditions.
Area of Science:
- Cardiovascular Surgery
- Diagnostic Imaging
Background:
- Transmural aortic injuries remain highly lethal.
- Diagnostic and therapeutic interventions have seen significant improvements.
Purpose of the Study:
- To review the evolution of diagnostic and therapeutic strategies for transmural aortic injuries.
- To analyze the Eastern Virginia Medical School (EVMS) experience over two decades.
Main Methods:
- Comparison of aortography and contrast-enhanced spiral thoracic computed tomography (CT) for diagnosis.
- Review of surgical repair methods including interposition prosthetic graft placement and endovascular stents.
- Analysis of patient data from EVMS over a 10-year period and midpoint of the second 10-year period (1997-2007).
Main Results:
- Contrast-enhanced spiral thoracic CT is emerging as a potential alternative to aortography.
- Fast spiral CT scanners offer advantages over earlier CT generations.
- Interposition prosthetic graft placement was the predominant repair method at EVMS, with no shunt use.
- Endovascular stent use in managing these injuries is under ongoing discussion.
Conclusions:
- Surgical repair techniques for transmural aortic injuries have evolved.
- The role of endovascular stents in managing aortic injuries requires further investigation.