Vascular geometry as a risk factor for non-penetrating traumatic injuries of the aortic arch

• Published in: PloS one 2017-06, Vol.12 (6), p.e0180066-e0180066
• Main Authors: Schicho, Andreas, Luerken, Lukas, Stroszczynski, Christian, Meier, Ramona, Schreyer, Andreas G, Dendl, Lena-Marie, Schleder, Stephan
• Format: Article
• Language: English
• Subjects: Adult; Age; Age Factors; Aged; Aneurysms; Angles (geometry); Aorta; Aorta - diagnostic imaging; Aorta - injuries; Aortic arch; Bifurcations; Biology and Life Sciences; Biomechanics; Blood pressure; Care and treatment; Computed tomography; Computed Tomography Angiography; Coronary vessels; Deceleration; Diagnosis; Emergency medical care; Female; Head; Humans; Injuries; Injury Severity Score; Male; Medical imaging; Medicine and Health Sciences; Middle Aged; Neck; Organ Size; Patients; Physical Sciences; Prospective Studies; Research and Analysis Methods; Risk Factors; Sex; Sex Factors; Thorax; Trauma; Whole Body Imaging; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0180066

To assess biomechanical factors in aortic arch geometry contributing to the development of non-penetrating aortic arch injury (NAAI) in multiply injured patients with an Injury Severity Score (ISS) ≥ 16. 230 consecutive multiply injured trauma patients with an ISS ≥ 16 admitted to our Level-I trauma center during a consecutive 24-month period were prospectively included of whom 13 presented with NAAI (5.7%). Standardized whole-body CT in a 2x128-detector-row scanner included a head-and-neck CTA. Aortic arch diameters, width, height, angles and thoracic width and height were measured in individuals with NAAI and ISS-, sex-, age-, and trauma mechanism-matched controls. There was no difference between groups regarding sex, age, ISS, and aortic diameters. The aortic arch angle in individuals with NAAI (71.3° ± 14.9°) was larger than in healthy control (60.7° ± 8.6°; p*