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Blunt thoracic aorta injuries, an Australian single centre's perspective
Krystal Dinh1,2, Alexandra Limmer2,3, Carlin Ngai2
1Department of Vascular Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
ANZ Journal of Surgery
|January 28, 2021
Summary
Blunt thoracic aortic injuries (BTAI) management has shifted to endovascular repair. This study shows adherence to guidelines, with TEVAR used for surgical cases and non-operative management for select Grade I injuries.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Emergency Medicine
Background:
- Blunt thoracic aortic injuries (BTAI) are critical emergencies.
- Management has evolved from open repair to endovascular techniques.
- Assessing local management trends against international standards is crucial.
Purpose of the Study:
- To evaluate the management trends of BTAI over a decade.
- To compare these trends with current international guidelines.
- To analyze outcomes associated with different management strategies.
Main Methods:
- Retrospective review of BTAI patients at a level one trauma center (2010-2019).
- Analysis of demographics, injury details, imaging, management, and outcomes.
- Diagnosis confirmed via computed tomography angiography.
Main Results:
- 39 BTAI cases identified; 17.9% mortality in the emergency department.
- 27 survivors treated with endovascular stent-graft (TEVAR); 5 managed non-operatively.
- No open surgical repairs; TEVAR had one death (non-BTAI related) and two endoleaks.
Conclusions:
- Local BTAI management aligns with international guidelines.
- Computed tomography angiography is standard for diagnosis and grading.
- TEVAR is the primary surgical approach; non-operative management is safe for select Grade I injuries.
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