skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Advances in Imaging and Management Trends of Traumatic Aortic Injuries

Abstract

Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients. We also briefly review the current literature on the definition, treatment, and follow-up protocol in patients with minimal aortic injury.

Authors:
;  [1];  [2];  [3];  [4]
  1. University of Iowa Hospitals and Clinics, Department of Radiology (United States)
  2. Mayo Clinic, Department of Vascular and Endovascular Surgery (United States)
  3. UT Southwestern Medical Center, Department of Radiology (United States)
  4. Mayo Clinic, Department of Radiology (United States)
Publication Date:
OSTI Identifier:
22645213
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 5; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; INJURIES; MANAGEMENT; PATIENTS; REVIEWS; VASCULAR DISEASES

Citation Formats

Nagpal, Prashant, E-mail: drprashantnagpal@gmail.com, E-mail: Prashant-nagpal@uiowa.edu, Mullan, Brian F., Sen, Indrani, Saboo, Sachin S., and Khandelwal, Ashish. Advances in Imaging and Management Trends of Traumatic Aortic Injuries. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1572-X.
Nagpal, Prashant, E-mail: drprashantnagpal@gmail.com, E-mail: Prashant-nagpal@uiowa.edu, Mullan, Brian F., Sen, Indrani, Saboo, Sachin S., & Khandelwal, Ashish. Advances in Imaging and Management Trends of Traumatic Aortic Injuries. United States. doi:10.1007/S00270-017-1572-X.
Nagpal, Prashant, E-mail: drprashantnagpal@gmail.com, E-mail: Prashant-nagpal@uiowa.edu, Mullan, Brian F., Sen, Indrani, Saboo, Sachin S., and Khandelwal, Ashish. Mon . "Advances in Imaging and Management Trends of Traumatic Aortic Injuries". United States. doi:10.1007/S00270-017-1572-X.
@article{osti_22645213,
title = {Advances in Imaging and Management Trends of Traumatic Aortic Injuries},
author = {Nagpal, Prashant, E-mail: drprashantnagpal@gmail.com, E-mail: Prashant-nagpal@uiowa.edu and Mullan, Brian F. and Sen, Indrani and Saboo, Sachin S. and Khandelwal, Ashish},
abstractNote = {Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients. We also briefly review the current literature on the definition, treatment, and follow-up protocol in patients with minimal aortic injury.},
doi = {10.1007/S00270-017-1572-X},
journal = {Cardiovascular and Interventional Radiology},
number = 5,
volume = 40,
place = {United States},
year = {Mon May 15 00:00:00 EDT 2017},
month = {Mon May 15 00:00:00 EDT 2017}
}
  • No abstract prepared.
  • Supra-aortic vessel injuries are uncommon but can be life-threatening and surgically challenging. Trauma to these vessels may be blunt or penetrating, including iatrogenic trauma following the insertion of central venous lines, which may be preventable. Recent advances in technology have resulted in endovascular therapy becoming a common first-line treatment, and interventional radiologists now play a major role in the management of these vascular injuries. We review the literature on the endovascular management of these types of injuries and describe a spectrum of case-based extra-cranial supra-aortic vascular injuries managed at our institution and the range of imaging appearances, including active contrast extravasation,more » traumatic vessel occlusion, true aneurysms, pseudoaneurysms, and arteriovenous fistulae.« less
  • No abstract prepared.
  • We successfully stabilized severe hemorrhagic shock following traumatic liver injury by percutaneous transcarotid supraceliac aortic occlusion with a 5 Fr balloon catheter. Then we were able to perform transfemoral embolization therapy of the hepatic arterial bleeding source. Transient aortic occlusion using a balloon catheter appears to be a useful adjunct in select cases where stabilization of the patient is necessary to allow successful selective embolization of the bleeding source.
  • Embolization using N-butyl-2-cyano-acrylate (NBCA) has been highly regarded for treating pseudoaneurysm, arteriovenous malformation, and hemorrhage of the visceral arteries. We report the case of a patient who fell from a cliff and sustained hemorrhagic shock with blunt abdominal aortic rupture and who underwent embolization using NBCA. This treatment achieved immediate hemostasis and stabilization of vital signs. Although the long-term durability of NBCA is unknown, it appears that certain types of acute aortic hemorrhage with narrow-necked pseudoaneurysm can be controlled by embolization using NBCA.