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Related Experiment Video

Updated: Jun 28, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Blunt thoracic aortic injury.

Elizabeth R Benjamin1, Areti Tillou, Jonathan R Hiatt

  • 1Division of General Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.

The American Surgeon
|October 24, 2008
PubMed
Summary
This summary is machine-generated.

Blunt thoracic aortic injury (BAI) is a rare but severe trauma. Aggressive use of CT angiography (CTA) is recommended for BAI diagnosis, even with unclear chest x-ray findings, to improve patient outcomes.

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Area of Science:

  • Trauma Surgery
  • Cardiovascular Surgery
  • Emergency Medicine

Background:

  • Blunt thoracic aortic injury (BAI) is a rare, often fatal consequence of severe polytrauma.
  • Prompt diagnosis and management are critical for improving outcomes in BAI patients.
  • BAI frequently co-occurs with other life-threatening injuries, complicating clinical presentation and treatment.

Purpose of the Study:

  • To review the experience with blunt thoracic aortic injury (BAI) management at a Level I trauma center.
  • To evaluate diagnostic modalities and treatment strategies for BAI.
  • To assess the impact of diagnostic imaging on patient outcomes.

Main Methods:

  • Retrospective review of 20 patients with BAI treated between 1995 and 2006.
  • Analysis of patient demographics, injury severity scores, associated injuries, and Glasgow Coma Scores.
  • Evaluation of diagnostic methods including chest x-ray (CXR), CT angiography (CTA), transesophageal echocardiography (TEE), and formal angiography.
  • Review of surgical interventions, including operative repair of BAI, laparotomy, extremity fracture repair, and pelvic embolization.

Main Results:

  • The mean Injury Severity Score was 38 +/- 14, with 14 patients having abnormal Glasgow Coma Scores.
  • Associated injuries were common, involving the abdomen (13 patients), extremities (12 patients), and head (6 patients).
  • Chest x-ray findings were suggestive in 15 patients, equivocal in 3, and negative in 2.
  • Diagnosis was established by CTA in 17 patients, TEE in 2, and angiography in 1.
  • Sixteen patients underwent operative repair; 5 patients died (3 nonoperatively).
  • Survivors had a mean hospitalization of 32 +/- 20 days.

Conclusions:

  • Blunt thoracic aortic injury (BAI) is a rare injury associated with high mortality and multiple comorbidities.
  • CT angiography (CTA) is a valuable tool for diagnosing BAI, even when chest x-ray findings are not definitive.
  • Intraoperative TEE can be useful when CT imaging is delayed due to the need for abdominal exploration.