Cross-sectional imaging of thoracic traumatic aortic                     injury

Hahn, Lewis D.; Prabhakar, Anand M.

doi:10.1024/0301-1526/a000741

Cited by 10 publications

(34 citation statements)

References 66 publications

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“…The direct signs of ATAI have the highest sensitivity and specificity (29). Direct signs of ATAI include pseudoaneurysm, focal contour abnormality, intimal flap, intramural hematoma, an abrupt change in aortic caliber, and contrast extravasation (Figure 3) (28).…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

“…Conversely, traumatic pseudoaneurysm will typically have a narrow base, irregular margins, and acute angles between the bulging and aortic wall. The presence of additional traumatic findings, including intimal flap or mediastinal hematoma, also favors pseudoaneurysm (29,31).…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

“…For instance, both cardiac and respiratory motion can create contour abnormalities that may be mistaken for traumatic injury (29). Typically, such pulsation artifacts appear on both sides of the aorta and occur near the aortic root.…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

“…An electrocardiogram (ECG)-gated CT can be performed to eliminate cardiac motion, if necessary (14,29).…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

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Acute traumatic injury of the aorta: presentation, diagnosis, and treatment

Brown¹,

Still²,

Eudailey³

et al. 2021

Ann Transl Med

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Despite advances in detection and treatment, acute traumatic aortic injury (ATAI) is associated with high rates of morbidity and mortality. Both physical and hemodynamic forces have been postulated as mechanisms of aortic injury during a traumatic event. For patients who survive the initial injury, rapid detection is critical for diagnosis and procedural planning, which requires a thorough knowledge of both its clinical presentation and the available diagnostic imaging modalities. Radiography, computed tomography (CT), and magnetic resonance imaging (MRI) can each have a role in the diagnosis of ATAI.After stabilization of the patient, the management of ATAI is guided by the severity of injury. Appropriately selected patients with low grade injuries may be managed non-operatively. When treatment is required, there are both open surgical and endovascular options. In current practice, endovascular approaches with stentgraft placement are preferred due to their high clinical success and low rates of complications. Complications from endograft placement can include: endoleak, endograft collapse, infection, endograft failure, and endograft migration. Open surgical repair is now reserved for patients with unfavorable anatomy for endovascular therapies. This review provides a comprehensive overview of ATAI including its epidemiology and demographics, mechanisms of injury, clinical and radiographic diagnosis, treatment options, and posttherapeutic follow-up.

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Section: Computed Tomography (Ct)mentioning

confidence: 99%

Section: Computed Tomography (Ct)mentioning

confidence: 99%

Section: Computed Tomography (Ct)mentioning

confidence: 99%

“…An electrocardiogram (ECG)-gated CT can be performed to eliminate cardiac motion, if necessary (14,29).…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

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Acute traumatic injury of the aorta: presentation, diagnosis, and treatment

Brown¹,

Still²,

Eudailey³

et al. 2021

Ann Transl Med

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“…1 und 3 a). Die indirekten Zeichen können zur Differenzierung hilfreich sein [ 15 , 35 ]. Daher ist eine EKG-Triggerung zur Diagnostik Läsionen im Bereich der Aortenwurzel und der Aorta ascendens essenziell [ 46 ].…”

Section: Diagnostikunclassified

Diagnostik und Therapie traumatischer Aortenverletzungen

Benz

Makaloski

Brönnimann³

et al. 2021

Unfallchirurg

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Zusammenfassung Hintergrund Traumatische Aortenverletzungen (TAV) sind seltene Folgen von stumpfen Traumata, die eine hohe Mortalität und Morbidität aufweisen. Die schnelle und akkurate Diagnostik sowie die Wahl der korrekten Therapie sind für das Patientenüberleben elementar. Fragestellung Bestimmung des aktuellen Standards der Abklärung von TAV im akuten Trauma-Setting und Evaluation der aktuellen Leitlinien zur Therapie. Material und Methode Eine Literaturrecherche wurde durchgeführt, mit der Suche nach Publikationen, die die Abklärung und Diagnostik der TAV beschreiben. Außerdem wurden Leitlinien für die Behandlung und Nachsorge von TAV zusammengefasst. Ergebnisse In der Literatur wird trotz geringer Spezifität eine konventionelle Thoraxröntgenaufnahme als Initialdiagnostik genannt. Es sollte primär, als Modalität der Wahl, zur Diagnostik und zur Therapiestratifizierung eine Computertomographie (CT) aufgrund der hohen Sensitivität und Spezifität nachfolgen. In allen Leitlinien ist die thorakale endovaskuläre Aortenrekonstruktion („thoracic endovascular aortic repair“, TEVAR) die Therapie der Wahl bei höhergradigen TAV (Grade II–IV) und hat die offene Chirurgie in dem meisten Fällen abgelöst. Schlussfolgerung Nach einer kurzfristig erfolgten CT-Diagnostik und Einteilung wird die TEVAR der offenen Chirurgie bei therapiebedürftigen TAV vorgezogen.

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