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Endovascular stent in traumatic thoracic aortic dissection.

Jang MO, Kim JH, Oh SK, Lee MG, Park KH, Sim DS, Hong YJ, Ahn Y, Jeong MH - Korean Circ J (2012)

Bottom Line: Traumatic thoracic aortic injury is typically fatal.Also, the morbidity and mortality associated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury.We experienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents.

View Article: PubMed Central - PubMed

Affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT
Traumatic thoracic aortic injury is typically fatal. However, recent improvements in pre-hospital care and diagnostic modalities have resulted in an increased number of patients with traumatic aortic injury arriving alive at the hospital. Also, the morbidity and mortality associated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury. We experienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents.

No MeSH data available.


Related in: MedlinePlus

Chest computed tomography angiogram shows traumatic aortic dissection in proximal descending thoracic aorta/distal aortic arch around aortic isthmus with left pleural effusion. A: aortic arch level. B: pulmonary artery level. C: anterior view. D: posterior view.
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Figure 1: Chest computed tomography angiogram shows traumatic aortic dissection in proximal descending thoracic aorta/distal aortic arch around aortic isthmus with left pleural effusion. A: aortic arch level. B: pulmonary artery level. C: anterior view. D: posterior view.

Mentions: A 28-year-old male suffered from a traffic accident while in a car. His mental status was confused but brain CT revealed non-specific findings. He had no known history of hypertension, diabetes, hepatitis, and pulmonary tuberculosis. He was an 8 pack-year current smoker. His family history was non-specific. On admission his vital signs were stable except for blood pressure of 100/70 mm Hg. A 12-lead electrocardiogram (EKG) showed normal sinus rhythm with 72 beat/min. The results of electrolyte panel and kidney function studies were all within normal limits. The aspartate aminotransferase (AST) was 70 U/L, alanine amino-transferase (ALT) was 47 U/L, creatinine kinase (CK) was 255 U/L and CK-MB was 28 U/L. However, serum level of troponin I was within normal limits. Initial 2-dimensional echocardiography (2DE) showed no regional wall motion abnormality with normal left ventricular ejection fraction, but chest CT angiogram (CTA) showed traumatic aortic dissection in proximal descending thoracic aorta/distal aortic arch around aortic isthmus with left pleural effusion (Fig. 1). Therefore, we performed a thoracic aortography, which showed an aortic aneurysm distal to the subclavian artery, for which a 24×112 mm valiant thoracic stent was implanted. Follow-up aortogram showed no evidence of leakage. Follow-up 2DE did not show evidence of turbulent flow or flow disturbance near the entrance of the left subclavian artery. Follow-up chest CTA showed vascular stent graft insertion state from distal aortic arch to proximal descending thoracic aorta and resolved state of previous traumatic aortic dissection (Fig. 2). After uneventful recovery, he was discharged on day 33 and has been followed up at the outpatient clinic.


Endovascular stent in traumatic thoracic aortic dissection.

Jang MO, Kim JH, Oh SK, Lee MG, Park KH, Sim DS, Hong YJ, Ahn Y, Jeong MH - Korean Circ J (2012)

Chest computed tomography angiogram shows traumatic aortic dissection in proximal descending thoracic aorta/distal aortic arch around aortic isthmus with left pleural effusion. A: aortic arch level. B: pulmonary artery level. C: anterior view. D: posterior view.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369966&req=5

Figure 1: Chest computed tomography angiogram shows traumatic aortic dissection in proximal descending thoracic aorta/distal aortic arch around aortic isthmus with left pleural effusion. A: aortic arch level. B: pulmonary artery level. C: anterior view. D: posterior view.
Mentions: A 28-year-old male suffered from a traffic accident while in a car. His mental status was confused but brain CT revealed non-specific findings. He had no known history of hypertension, diabetes, hepatitis, and pulmonary tuberculosis. He was an 8 pack-year current smoker. His family history was non-specific. On admission his vital signs were stable except for blood pressure of 100/70 mm Hg. A 12-lead electrocardiogram (EKG) showed normal sinus rhythm with 72 beat/min. The results of electrolyte panel and kidney function studies were all within normal limits. The aspartate aminotransferase (AST) was 70 U/L, alanine amino-transferase (ALT) was 47 U/L, creatinine kinase (CK) was 255 U/L and CK-MB was 28 U/L. However, serum level of troponin I was within normal limits. Initial 2-dimensional echocardiography (2DE) showed no regional wall motion abnormality with normal left ventricular ejection fraction, but chest CT angiogram (CTA) showed traumatic aortic dissection in proximal descending thoracic aorta/distal aortic arch around aortic isthmus with left pleural effusion (Fig. 1). Therefore, we performed a thoracic aortography, which showed an aortic aneurysm distal to the subclavian artery, for which a 24×112 mm valiant thoracic stent was implanted. Follow-up aortogram showed no evidence of leakage. Follow-up 2DE did not show evidence of turbulent flow or flow disturbance near the entrance of the left subclavian artery. Follow-up chest CTA showed vascular stent graft insertion state from distal aortic arch to proximal descending thoracic aorta and resolved state of previous traumatic aortic dissection (Fig. 2). After uneventful recovery, he was discharged on day 33 and has been followed up at the outpatient clinic.

Bottom Line: Traumatic thoracic aortic injury is typically fatal.Also, the morbidity and mortality associated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury.We experienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents.

View Article: PubMed Central - PubMed

Affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT
Traumatic thoracic aortic injury is typically fatal. However, recent improvements in pre-hospital care and diagnostic modalities have resulted in an increased number of patients with traumatic aortic injury arriving alive at the hospital. Also, the morbidity and mortality associated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury. We experienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents.

No MeSH data available.


Related in: MedlinePlus