Open vs endovascular repair of blunt traumatic thoracic aortic injuries

• Published in: Journal of vascular surgery Vol. 51; no. 3; pp. 763 - 769
• Main Authors: Rheaume, Pascal, MD, Chen, Jerry, MD, Casey, Patrick, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.03.2010
• Subjects: Accidents, Traffic; Adult; Aneurysm, False - diagnostic imaging; Aneurysm, False - etiology; Aneurysm, False - surgery; Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - injuries; Aorta, Thoracic - surgery; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - etiology; Aortic Aneurysm, Thoracic - surgery; Aortography - methods; Evidence-Based Medicine; Female; Hematoma - diagnostic imaging; Hematoma - etiology; Hematoma - surgery; Humans; Patient Selection; Practice Guidelines as Topic; Risk Assessment; Surgery; Tomography, X-Ray Computed; Treatment Outcome; Vascular Surgical Procedures - adverse effects; Wounds and Injuries - diagnostic imaging; Wounds and Injuries - surgery
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2009.12.014

A 42-year-old female is involved in a motor vehicle accident and presents with a number of injuries. She is hemodynamically stable and is found to have multiple rib fractures, a hemopneumothorax, and several uncomplicated long bone fractures. A CT scan of her chest reveals a traumatic injury to her proximal descending thoracic aorta with evidence of pseudoaneurysm formation and surrounding hematoma ( Fig 1 ). The following debate attempts to resolve whether open repair remains the gold standard for the treatment of blunt thoracic aortic injuries.