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钝性胸主动脉损伤

Blunt Thoracic Aortic Injury.

作者信息

Mazzaccaro Daniela, Righini Paolo, Fancoli Fabiana, Giannetta Matteo, Modafferi Alfredo, Malacrida Giovanni, Nano Giovanni

机构信息

Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy.

Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy.

出版信息

J Clin Med. 2023 Apr 17;12(8):2903. doi: 10.3390/jcm12082903.

Abstract

Blunt thoracic aortic injury (BTAI) is a potentially fatal condition that needs prompt recognition and expedited management. Clinical manifestations of BTAI are not straight forwarding and may be misdiagnosed. The grade of aortic injury is an important determinant of perioperative mortality and morbidity, as well as the indication of treatment, along with the presence of concomitant lesions of other involved organs. The mainstay of treatment nowadays for hemodynamically stable patients who survive the trauma scene is represented by delayed endovascular repair whenever anatomically and clinically feasible. Endovascular repair, in fact, is burdened by lower perioperative mortality and morbidity rates if compared to open surgical repair, but concerns remain about the need for long-term surveillance and radiation exposure in patients who are at a younger age than patients treated for the aneurysmal disease. The aim of the paper is to provide an update on the diagnostic modalities and strategies of treatment for patients affected by BTAI.

摘要

钝性胸主动脉损伤(BTAI)是一种潜在的致命疾病,需要及时识别和快速处理。BTAI的临床表现并不直接,可能会被误诊。主动脉损伤的分级是围手术期死亡率和发病率的重要决定因素,也是治疗指征,同时还涉及其他受累器官的伴随病变情况。对于在创伤现场存活下来的血流动力学稳定的患者,目前主要的治疗方法是在解剖学和临床上可行的情况下进行延迟血管内修复。事实上,与开放手术修复相比,血管内修复的围手术期死亡率和发病率较低,但对于年龄比接受动脉瘤疾病治疗的患者更小的患者,长期监测的必要性和辐射暴露问题仍然令人担忧。本文的目的是提供有关BTAI患者诊断方法和治疗策略的最新信息。

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