Hardy Warren N, Shah Chirag S, Mason Matthew J, Kopacz James M, Yang King H, King Albert I, Van Ee Chris A, Bishop Jennifer L, Banglmaier Richard F, Bey Michael J, Morgan Richard M, Digges Kennerly H
Wayne State University.
Stapp Car Crash J. 2008 Nov;52:233-65. doi: 10.4271/2008-22-0010.
This study investigated the mechanisms of traumatic rupture of the aorta (TRA). Eight unembalmed human cadavers were tested using various dynamic blunt loading modes. Impacts were conducted using a 32-kg impactor with a 152-mm face, and high-speed seatbelt pretensioners. High-speed biplane x-ray was used to visualize aortic motion within the mediastinum, and to measure deformation of the aorta. An axillary thoracotomy approach was used to access the peri-isthmic region to place radiopaque markers on the aorta. The cadavers were inverted for testing. Clinically relevant TRA was observed in seven of the tests. Peak average longitudinal Lagrange strain was 0.644, with the average peak for all tests being 0.208 +/- 0.216. Peak intraluminal pressure of 165 kPa was recorded. Longitudinal stretch of the aorta was found to be a principal component of injury causation. Stretch of the aorta was generated by thoracic deformation, which is required for injury to occur. The presence of atherosclerosis was demonstrated to promote injury. The isthmus of the aorta moved dorsocranially during frontal impact and submarining loading modes. The aortic isthmus moved medially and anteriorly during impact to the left side. The results of this study provide a better understanding of the mechanisms associated with TRA, and can be used for the validation of finite element models developed for the examination and prediction of TRA.
本研究调查了主动脉创伤性破裂（TRA）的机制。使用各种动态钝性加载模式对8具未防腐处理的人体尸体进行了测试。使用一个32千克、面部直径为152毫米的撞击器以及高速安全带预紧器进行撞击。利用高速双平面X射线观察纵隔内主动脉的运动，并测量主动脉的变形情况。采用腋部开胸手术入路，进入峡部周围区域，在主动脉上放置不透射线的标记物。将尸体倒置进行测试。在7次测试中观察到了具有临床相关性的TRA。平均纵向拉格朗日应变峰值为0.644，所有测试的平均峰值为0.208±0.216。记录到的腔内压力峰值为165千帕。发现主动脉的纵向拉伸是损伤成因的一个主要因素。主动脉的拉伸是由胸廓变形产生的，而这种变形是损伤发生所必需的。已证明动脉粥样硬化的存在会促进损伤。在正面撞击和潜没加载模式下，主动脉峡部向背侧头侧移动。在左侧受到撞击时，主动脉峡部向内侧和前方移动。本研究结果有助于更好地理解与TRA相关的机制，并可用于验证为检查和预测TRA而开发的有限元模型。
