Document Detail


The role of CT angiography in the diagnosis of blunt traumatic thoracic aortic disruption and unsuspected carotid artery injury.
MedLine Citation:
PMID:  18646474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have replaced aortography and open thoracic surgery to diagnose and treat blunt traumatic thoracic aortic disruption (TTAD) in favor of CT angiography (CTA) and endovascular repair. The purpose of this study is to review our experience with the management and outcomes of TTAD and associated carotid artery injuries. In January 2003, we initiated a protocol that used CTA to evaluate all patients with suspected TTAD from blunt trauma. When TTAD was diagnosed, patients were managed by endovascular repair using abdominal aortic extension cuffs. Twenty-nine patients with TTAD were managed by endovascular repair. In all patients, abdominal endograft extension cuffs successfully excluded the traumatic disruptions. Six (21%) of these patients had concomitant, unsuspected carotid artery injury diagnosed by CTA. One patient had bilateral carotid artery dissections, sustained irreversible brain injury, and died. Four patients with common carotid dissections were successfully treated by anticoagulation and made uneventful recoveries. One patient with a common carotid-innominate artery dissection and pseudoaneurysm underwent endovascular repair. This study indicates that CTA and endovascular repair provide accurate diagnostic and therapeutic results in the management of blunt TTAD. Furthermore, CTA should include arch and cervical views to detect an unsuspected, concomitant carotid artery injury.
Authors:
Walaya C Methodius-Ngwodo; Allison B Burkett; Paul V Kochupura; Eric D Wellons; George Fuhrman; David Rosenthal
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  74     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-23     Completed Date:  2008-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  580-5; discussion 585-6     Citation Subset:  IM    
Affiliation:
Department of Trauma Surgery, Atlanta Medical Center, Atlanta, Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aneurysm, False / etiology,  radiography,  surgery
Angiography / methods*
Aorta, Thoracic / injuries*,  radiography,  surgery
Aortic Aneurysm, Thoracic / etiology,  radiography,  surgery
Carotid Artery Injuries / etiology,  radiography*,  surgery
Carotid Artery, Common / radiography*,  surgery
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Reproducibility of Results
Retrospective Studies
Thoracic Injuries / radiography*,  surgery
Tomography, X-Ray Computed / methods*
Trauma Severity Indices
Vascular Surgical Procedures / methods
Wounds, Nonpenetrating / radiography*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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