Hamed Ghoddusi Johari; Seyed Arman Moein; Ahmad Hosseinzadeh; Javad Kojuri; Amirhossein Roshanshad; Reza Shahriarirad
Volume 10, Issue 3 , July 2022, , Pages 103-109
Abstract
Objective: To evaluate the efficacy of chest x-ray (CXR) in blunt traumatic aortic injury (BTAI) as a primaryimaging tool in trauma patients.Methods: We retrospectively reviewed our hospital records for blunt thoracic aortic injury patients who had atherapeutic intervention from January 2015 to February ...
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Objective: To evaluate the efficacy of chest x-ray (CXR) in blunt traumatic aortic injury (BTAI) as a primaryimaging tool in trauma patients.Methods: We retrospectively reviewed our hospital records for blunt thoracic aortic injury patients who had atherapeutic intervention from January 2015 to February 2021. Patients’ characteristics, initial chest x-rays, andcomputed tomography (CT) scan were extracted and re-evaluated.Results: Eighteen patients matched the criteria of our research. The mean age and the injury severity score(ISS) was 29.8±11.2 and 38.4±14.4, respectively. Seven patients (38.9%) underwent thoracic endovascularaortic repair (TEVAR), and 11 (61.1%) had open surgery. The TEVAR group had significantly lower meanintensive care unit stay days (6.6±3.9 vs. 10.8±6.9 in open aortic repair (OAR), p<0.05). The percentile ofpatients requiring blood transfusion was significantly lower in the TEVAR group (57% vs. 100% in OAR,p<0.05). Mediastinal widening (66.7%) was the most common finding during the evaluation of initial chestx-rays. Interestingly, 22.2% of the initial x-rays were not remarkable for BTAI.Conclusion: TEVAR is an advantageous choice in the management of BTAI. However, open aortic repair is theoptimal decision in certain situations. It is suggested that the Interventional management of the BTAI must beperformed by experienced vascular surgeons in a medical center capable of both OAR and TEVAR.
Saptarshi Biswas; Boris Hristov
Volume 5, Issue 4 , October 2017, , Pages 303-306
Abstract
Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical ...
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Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical signs and symptoms years later. Open surgical repair can have prohibitive morbidity and mortality and endovascular techniques, an effective treatment alternative, can interrupt the abnormal vascular communication and preserve artery vein patency. We describe a unique case of iliac arteriovenous fistula (AVF), secondary to a bullet injury, identified by imaging studies and subsequently treated with endovascular surgery. In conclusion, traumatic AVF are rare. Traditional teaching mandates that zone III pelvic retroperitoneal hematomas secondary to penetrating trauma be explored.
