Choice of diagnosis and therapeutic strategy of the blunt traumatic aortic injury

AIM To investigate the diagnosis, optimal time to intervention and operation strategy of blunt traumatic aortic injury. METHODS The present investigation reviewed diagnosis, time of operation, and strategy of operation of 17 patients with blunt traumatic aortic injury between October 2007 and December 2016. Among the 17 patients, 15 sustained blunt thoracic aortic injuries distal to the origin of the left subclavian artery and 2 patients sustained blunt abdominal aorta injuries. RESULTS The injuries included car collisions (12 cases), motor collision (1 case), high falls (2 cases), abdominal crush (1 case) and repeated chest strikes by cable drilling tools (1 case). The diagnoses were made from 6 hours to 15 days after injury. Thirteen patients received thoracic endovascular repair, 1 patient received abdominal aorta replacement with a "Y" branched artificial vascular repair, 1 patient with abdominal aortic aneurysm was followed up, and 2 patients died without operation. CONCLUSION Blunt traumatic aortic injury is easily diagnosed using computer tomography angiography (CTA). The optimal time of operation should be decided according to aorta injury degree, combined with injury and secondary signs of the injury. Thoracic endovascular repair may be the optimal choice for the thoracic aorta injuries distal to the origin of left subclavian artery.