Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;8(6):163-168.
doi: 10.1055/s-0040-1715608. Epub 2021 Mar 24.

Blunt Traumatic Aortic Injury: 10-Year Single-Center Experience

Ahmet Can Topcu  1 , Kamile Ozeren-Topcu  1 , Ahmet Bolukcu  1 , Sinan Sahin  2 , Avni U Seyhan  3 , Ilyas Kayacioglu  1
Affiliations

Blunt Traumatic Aortic Injury: 10-Year Single-Center Experience

Ahmet Can Topcu et al. Aorta (Stamford). 2020 Dec.

Abstract

Objective: In blunt trauma patients, injury of the thoracic aorta is the second most common cause of death after head injury. In recent years, thoracic endovascular aortic repair (TEVAR) has largely replaced open repair as the primary treatment modality, and delayed repair of stable aortic injuries has been shown to improve mortality. In light of these major advancements, we present a 10-year institutional experience from a tertiary cardiovascular surgery center.

Methods: Records of patients who underwent endovascular or open repair of the ascending, arch or descending thoracic aorta between January 2009 and December 2018 were retrospectively analyzed. Patients without blunt traumatic etiology were excluded. Perioperative data were retrospectively collected from patient charts. Long-term follow-up was performed via data from follow-up visits and phone calls.

Results: A total of 1,667 patients underwent 1,740 thoracic aortic procedures (172 TEVAR and 1,568 open repair). There were 13 patients (12 males) with a diagnosis of blunt thoracic aortic injury. Mean patient age was 43.6 years (range, 16-80 years). Ten (77%) patients underwent TEVAR, two (15.4%) underwent open repair, and one (7.7%) was treated nonoperatively. Procedure-related stroke was observed in one (7.7%) case. Procedure-related paraplegia did not occur in any patients. Left subclavian artery origin was covered in seven patients. None developed arm ischemia. Hospital survivors were followed-up for an average of 60.2 months (range, 4-115 months) without any late mortality, endoleak, stent migration, arm ischemia, or reintervention.

Conclusion: Blunt thoracic aortic injury is a rare but highly fatal condition. TEVAR offers good early and midterm results. Left subclavian artery coverage can be performed without major complications.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest related to this article.

Figures

Fig. 1
Fig. 1
Computed tomography angiogram demonstrating aortic isthmus pseudoaneurysm, mediastinal hematoma and left hemothorax after blunt trauma.
Fig. 2
Fig. 2
Follow-up computed tomography angiogram after endovascular repair for blunt thoracic aortic injury.
Fig. 3
Fig. 3
( A ) Arch aortogram demonstrating aortic isthmus pseudoaneurysm; ( B ) successful endovascular repair.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. DuBose J J, Leake S S, Brenner M et al.Contemporary management and outcomes of blunt thoracic aortic injury: a multicenter retrospective study. J Trauma Acute Care Surg. 2015;78(02):360–369. - PubMed
    1. Kenel-Pierre S, Ramos Duran E, Abi-Chaker A et al.The role of heparin in endovascular repair of blunt thoracic aortic injury. J Vasc Surg. 2019;70(06):1809–1815. - PubMed
    1. Hasjim B J, Grigorian A, Barrios C, Jr. et al.National trends of thoracic endovascular aortic repair versus open thoracic aortic repair in pediatric blunt thoracic aortic injury. Ann Vasc Surg. 2019;59:150–157. - PubMed
    1. Parmley L F, Mattingly T W, Manion W C, Jahnke E J., Jr Nonpenetrating traumatic injury of the aorta. Circulation. 1958;17(06):1086–1101. - PubMed
    1. Fox N, Schwartz D, Salazar J H et al.Evaluation and management of blunt traumatic aortic injury: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2015;78(01):136–146. - PubMed