Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492007000100009
Jornal Vascular Brasileiro
Review Article

Current diagnosis and management of blunt traumatic rupture of the thoracic aorta

Estado atual do diagnóstico e tratamento das lesões traumáticas da aorta torácica

Vishal Bansal; Jeanne Lee; Raul Coimbra

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Abstract

The diagnosis and management of aortic lacerations has been gradually improving. Historically, aortic lacerations were a common cause of exsanguination with extremely high mortality rate. However, in modern trauma systems with advanced resuscitation and rapid radiology imaging, the diagnosis of an aortic injury is improving with an emphasis on preventing the progression of intimal flaps and pseudoaneurysms to frank dissection or rupture. Both diagnostic modalities and the paradigm of immediate operative intervention have changed. The evolution of endovascular stenting may play a future role in definitive care.

Keywords

Thoracic trauma, thoracic aorta, thoracic aortic rupture, endovascular repair, endoprosthesis, stent graft, paraplegia

Resumo

O diagnóstico e tratamento das lesões traumáticas da aorta torácica vêm gradualmente melhorando. Historicamente, as lesões traumáticas da aorta torácica eram causa freqüente de exanguinação, apresentando altas taxas de mortalidade. Por outro lado, após o desenvolvimento de sistemas modernos de atendimento às vítimas de traumatismos, com protocolos avançados de reanimação volêmica e rápida avaliação radiológica, o diagnóstico de lesões da aorta torácica tem melhorado significativamente. A ênfase atual está centrada na prevenção da progressão das lesões intimais menores e pseudo-aneurismas até a dissecção franca ou ruptura aórtica. As modalidades diagnósticas sofreram alterações, bem como o paradigma de intervenção cirúrgica imediata. A evolução de próteses endovasculares poderá desempenhar um importante papel no tratamento definitivo.

Palavras-chave

Trauma torácico, aorta torácica, ruptura traumática da aorta torácica, tratamento endovascular, endoprótese, paraplegia

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