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A 14-year experience with blunt thoracic aortic injury
Jennifer Watson1, Jeffrey Slaiby, Manuel Garcia Toca
1Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA. jenna.williams51681@gmail.com
Journal of Vascular Surgery
|June 13, 2013
Summary
Blunt thoracic aortic trauma (BTAT) has high mortality. Endovascular repair shows reduced complications and shorter hospital stays compared to open repair for BTAT patients.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Blunt thoracic aortic trauma (BTAT) is a rare but severe injury.
- Historically, open surgical repair was the standard treatment for BTAT.
Purpose of the Study:
- To review the natural history of BTAT.
- To compare outcomes of open versus endovascular repair for BTAT.
Main Methods:
- Retrospective analysis of 129 BTAT patients from 1998-2011 at a level 1 trauma center.
- Data collection included demographics, injury severity, and short- to midterm outcomes.
- Comparison of open repair (n=36) versus endovascular repair (n=14).
Main Results:
- Endovascular repair group had significantly lower mortality (7% vs 42% ≤30 days), stroke (7% vs 9%), and no paralysis or renal failure.
- Open repair group experienced higher rates of death, stroke, paralysis, myocardial infarction, and need for hemodialysis.
- Average length of stay was shorter for endovascular repair (15 days) compared to open repair (24 days).
Conclusions:
- BTAT incidence is low, but mortality is significant.
- Management preference shifted towards endovascular repair over the study period.
- Endovascular repair demonstrated superior outcomes in terms of mortality, complications, and length of stay.
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