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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

Follow-up chest computed tomography angiogram shows graft insertion state from distal aortic arch to proximal descending thoracic aorta and resolved state of previous traumatic aortic dissection.
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Figure 4: Follow-up chest computed tomography angiogram shows graft insertion state from distal aortic arch to proximal descending thoracic aorta and resolved state of previous traumatic aortic dissection.

Mentions: A 52-year-old male suffered from a traffic accident in a car. He complained of left flank pain and had multiple left rib fracture. He had no known history of hypertension, hepatitis, or pulmonary tuberculosis, but had been on diabetes medication for 3 years. He was a non-smoker and non-alcoholic drinker, and his family history was non-specific. On admission his blood pressure was 70/40 mm Hg. EKG showed sinus tachycardia with 138 beats/min. The results of electrolyte panel and kidney function studies were all within normal limits. The AST was 219 U/L, ALT was 153 U/L, CK was 2113 U/L, CK-MB was 51.7 U/L and troponin I was 0.24 U/L. Initial chest CTA showed traumatic aortic dissection in distal aortic arch/proximal descending thoracic aorta with surrounding hematoma (Fig. 3). The patient underwent medical treatment for 3 weeks, but follow-up chest CTA showed no remarkable change of traumatic aortic dissection and increased amount of bilateral hemothoraces. Based on this information, we performed the thoracic aortography on day 24. Aortogram revealed dissecting aneurysm approximately 1 cm distal from the left subclavian artery ostium. Stenting was performed using a 26×112 mm valiant thoracic stent graft. Follow-up aortogram showed good expansion of the stent without dye leakage. Follow-up chest CTA showed a graft insertion state from the distal aortic arch to the proximal descending thoracic aorta and a resolved state of a previous traumatic aortic dissection (Fig. 4). After uneventful recovery, he was discharged on day 34 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)

Follow-up chest computed tomography angiogram shows graft insertion state from distal aortic arch to proximal descending thoracic aorta and resolved state of previous traumatic aortic dissection.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Follow-up chest computed tomography angiogram shows graft insertion state from distal aortic arch to proximal descending thoracic aorta and resolved state of previous traumatic aortic dissection.
Mentions: A 52-year-old male suffered from a traffic accident in a car. He complained of left flank pain and had multiple left rib fracture. He had no known history of hypertension, hepatitis, or pulmonary tuberculosis, but had been on diabetes medication for 3 years. He was a non-smoker and non-alcoholic drinker, and his family history was non-specific. On admission his blood pressure was 70/40 mm Hg. EKG showed sinus tachycardia with 138 beats/min. The results of electrolyte panel and kidney function studies were all within normal limits. The AST was 219 U/L, ALT was 153 U/L, CK was 2113 U/L, CK-MB was 51.7 U/L and troponin I was 0.24 U/L. Initial chest CTA showed traumatic aortic dissection in distal aortic arch/proximal descending thoracic aorta with surrounding hematoma (Fig. 3). The patient underwent medical treatment for 3 weeks, but follow-up chest CTA showed no remarkable change of traumatic aortic dissection and increased amount of bilateral hemothoraces. Based on this information, we performed the thoracic aortography on day 24. Aortogram revealed dissecting aneurysm approximately 1 cm distal from the left subclavian artery ostium. Stenting was performed using a 26×112 mm valiant thoracic stent graft. Follow-up aortogram showed good expansion of the stent without dye leakage. Follow-up chest CTA showed a graft insertion state from the distal aortic arch to the proximal descending thoracic aorta and a resolved state of a previous traumatic aortic dissection (Fig. 4). After uneventful recovery, he was discharged on day 34 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