Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Surg Today. 2013 Dec;43(12):1339-46. doi: 10.1007/s00595-012-0471-7. Epub 2013 Jan 23.
A traumatic thoracic aortic injury is a severe and life-threatening clinical entity. Although largely fatal; if untreated, these injuries are amenable to surgical repair if appropriately diagnosed. Therefore, early triage of this condition is critically important. Unfortunately, aortic injuries rarely occur in isolation, and there has been no good cutoff value to help select the appropriate surgical strategy. Algorithms for the both diagnosis and treatment of traumatic thoracic aortic injury have undergone changes in recent years. There have been several case reports, retrospective series and registry data describing the treatment of patients with traumatic thoracic aortic rupture using endovascular treatment. Endovascular treatment is a less-invasive management option for polytraumatized patients. Because it is less invasive, without the need for thoracotomy or the use of heparin, endovascular repair can be performed even in acutely injured patients, without the risk of destabilizing pulmonary, head or abdominal traumatic lesions. Long-term follow-up especially in young patients is necessary after endovascular treatment.
创伤性胸主动脉损伤是一种严重且危及生命的临床病症。尽管这些损伤如果未经治疗,大多会致命,但如果得到适当诊断,是可以通过手术修复的。因此,早期对这种病症进行分诊至关重要。不幸的是,主动脉损伤很少单独发生,也没有很好的截断值来帮助选择合适的手术策略。近年来,创伤性胸主动脉损伤的诊断和治疗算法发生了变化。已经有一些病例报告、回顾性系列和登记数据描述了使用血管内治疗治疗创伤性胸主动脉破裂的患者。血管内治疗是一种对多发伤患者更具侵入性的管理选择。因为它的侵入性较小,无需开胸手术或使用肝素,血管内修复甚至可以在急性损伤的患者中进行,而不会有使肺部、头部或腹部创伤性病变不稳定的风险。血管内治疗后需要进行长期随访,特别是在年轻患者中。