Management of the traumatic aortic blunt injury in 2014

• Published in: La Presse médicale (1983) 2015-03, Vol.44 (3), p.305-316
• Main Authors: Noly, Pierre-Emmanuel, Mercier, Olaf, Angel, Claude, Fabre, Dominique, Mussot, Sacha, Brenot, Philippe, Riou, Jean-Yves, Bourkaib, Riad, Planché, Olivier, Dartevelle, Philippe, Fadel, Elie
• Format: Article
• Language: fre
• Subjects: Aorta, Thoracic - injuries; Aortic Rupture - diagnosis; Aortic Rupture - epidemiology; Aortic Rupture - therapy; Endovascular Procedures - methods; Endovascular Procedures - standards; Endovascular Procedures - trends; Hospital Mortality; Humans; Practice Guidelines as Topic - standards; Thoracic Injuries - diagnosis; Thoracic Injuries - epidemiology; Thoracic Injuries - therapy; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - epidemiology; Wounds, Nonpenetrating - therapy
• ISSN: 2213-0276
• DOI: 10.1016/j.lpm.2014.06.026

Diagnosis of blunt thoracic aortic injury (BAI) should be considered in any serious polytrauma. The diagnosis is mainly based on the CT scan at baseline. Life-threatening lesions are often associated with BAI. Hospital mortality is mainly due to associated lesions. Except the complete rupture of the aorta, treatment should be initiated after hemodynamic and respiratory stabilization of the patient and after the treatment of a lesion involving the immediate prognosis. Endovascular treatment of BAI became the treatment of choice, especially for patients with severe associated injuries and bleeding risk. Additional data on the long-term stents are necessary in these young patients. Conventional surgical treatment is always indicated for young subjects with stable hemodynamic, low risk of bleeding and when surgery may be delayed several hours.