Trauma to the aorta and aortic arch branches

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Diagnostic Imaging

Background:

• Deceleration and crushing chest injuries pose a significant risk to the thoracic aorta and its branches.
• While traumatic aortic rupture is well-studied, injuries to the aortic arch branches are frequently under-recognized.
• Effective diagnosis and management of thoracic arterial injuries are crucial for patient outcomes.

Purpose of the Study:

• To highlight the under-recognized issue of aortic arch branch injuries resulting from chest trauma.
• To review current and emerging diagnostic modalities for thoracic arterial injuries.
• To discuss evolving treatment strategies for traumatic aortic injuries.

Main Methods:

• Review of current literature on thoracic arterial injuries, focusing on diagnostic imaging and treatment advancements.
• Comparison of traditional angiography with newer modalities like computed tomography and transesophageal echocardiography.
• Analysis of recent developments in medical and endovascular management of aortic injuries.

Main Results:

• Angiography remains the gold standard for diagnosing suspected thoracic arterial injuries.
• Computed tomography and transesophageal echocardiography are increasingly used for serial monitoring of conservatively managed aortic injuries.
• New treatment options include medical management, delayed surgical repair, and endovascular stent-graft deployment.

Conclusions:

• Aortic arch branch injuries are a significant and often overlooked consequence of chest trauma.
• Advancements in imaging technologies are improving the diagnosis and monitoring of thoracic arterial injuries.
• Emerging treatment strategies offer new possibilities but also present complex management questions for thoracic arterial injuries.