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Published on: October 20, 2023
Aortic endograft sizing in trauma patients with hemodynamic instability
Frederik H W Jonker1, Hence J M Verhagen, Hamid Mojibian
1Sections of Vascular Surgery, Interventional Radiology, and Trauma, Surgical Critical Care and Surgical Emergencies, Yale University School of Medicine, New Haven, CT 06510, USA.
Journal of Vascular Surgery
|May 25, 2010
Summary
Aortic diameter significantly decreases in hemodynamically unstable trauma patients. This finding is critical for accurate sizing of endovascular aortic repair (TEVAR) in traumatic thoracic aortic injury (TTAI) cases.
Area of Science:
- Trauma care
- Vascular surgery
- Diagnostic imaging
Background:
- Hemodynamic instability is common in trauma patients.
- Accurate aortic measurements are crucial for endovascular aortic repair (TEVAR).
Purpose of the Study:
- To assess changes in aortic diameter in hemodynamically unstable trauma patients.
- To evaluate the impact on thoracic endovascular aortic repair (TEVAR) sizing for traumatic thoracic aortic injury (TTAI).
Main Methods:
- Retrospective analysis of trauma patients with hemodynamic instability.
- Comparison of initial CT scans with control CT scans for aortic diameter measurements.
- Blinded review by a cardiovascular radiologist using paired Student t test.
Main Results:
- Aortic diameter was significantly larger on control CTs compared to initial CTs in unstable patients.
- A mean increase in aortic diameter of +12.6% was observed at the mid descending thoracic aorta and infrarenal aorta in patients with pulse >or=130/min.
- These changes were consistent across all evaluated aortic levels.
Conclusions:
- Aortic diameter significantly decreases during hemodynamic instability in trauma patients.
- This reduction may lead to undersizing of endografts in TTAI patients requiring TEVAR.
- Further research is needed to accurately predict aortic diameters in unstable patients for endovascular repair.
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