Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly
Abstract Blunt thoracic aortic injury (BTAI) is a critical clinical emergency often presenting as severe trauma. The early diagnosis and treatment of BTAI pose significant challenges in its management, especially when patients experience early-stage hemodynamic instability. Presently, in the context...
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| Language: | English |
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BMC
2025-04-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-025-03391-0 |
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| author | Lei Wang Huamin Ge Ziyi Wang Haiping Zhao Yufang Zhang Shouyin Jiang Shanxiang Xu |
| author_facet | Lei Wang Huamin Ge Ziyi Wang Haiping Zhao Yufang Zhang Shouyin Jiang Shanxiang Xu |
| author_sort | Lei Wang |
| collection | DOAJ |
| description | Abstract Blunt thoracic aortic injury (BTAI) is a critical clinical emergency often presenting as severe trauma. The early diagnosis and treatment of BTAI pose significant challenges in its management, especially when patients experience early-stage hemodynamic instability. Presently, in the context of multiple traumas, there is an absence of clearly-defined and comprehensive guidelines capable of accurately determining the optimal timing and sequence of interventions for aortic injuries. This issue is particularly prominent when aortic injuries are complicated by abdominal vascular injuries, which exacerbate hemodynamic instability. This study aims to present two distinct cases of patients with BTAI complicated by pelvic vascular injuries, resulting in hemodynamic instability. These cases were treated at different trauma centers. The successful treatment strategies included the implantation of covered stents for aortic repair and arterial embolization for pelvic vascular injuries. By sharing these cases, we intend to enhance the understanding of the complex management of such combined - injury situations. We underscore that comprehensive aortic computed tomography angiography (CTA) is of crucial importance in the early detection of aortic injuries and other major vascular injuries in high-energy trauma scenarios. Although regional trauma centers have demonstrated positive impacts on patient outcomes, the retrospective nature of this study and its limited sample size necessitate further large-scale research to validate our findings and proposed management strategies. |
| format | Article |
| id | doaj-art-0efae16f9e2e4a7b859f9a32c6dc7e01 |
| institution | DOAJ |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-0efae16f9e2e4a7b859f9a32c6dc7e012025-08-20T03:04:53ZengBMCJournal of Cardiothoracic Surgery1749-80902025-04-012011810.1186/s13019-025-03391-0Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderlyLei Wang0Huamin Ge1Ziyi Wang2Haiping Zhao3Yufang Zhang4Shouyin Jiang5Shanxiang Xu6Department of Emergency Medicine, Second Affiliated Hospital Zhejiang University School of MedicineDepartment of Psychiatry, First People’s Hospital of YuhangZhejiang University-University of Edinburgh InsititutePeople’s Hospital of Haiyan CountyDepartment of Emergency Medicine, Second Affiliated Hospital Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital Zhejiang University School of MedicineAbstract Blunt thoracic aortic injury (BTAI) is a critical clinical emergency often presenting as severe trauma. The early diagnosis and treatment of BTAI pose significant challenges in its management, especially when patients experience early-stage hemodynamic instability. Presently, in the context of multiple traumas, there is an absence of clearly-defined and comprehensive guidelines capable of accurately determining the optimal timing and sequence of interventions for aortic injuries. This issue is particularly prominent when aortic injuries are complicated by abdominal vascular injuries, which exacerbate hemodynamic instability. This study aims to present two distinct cases of patients with BTAI complicated by pelvic vascular injuries, resulting in hemodynamic instability. These cases were treated at different trauma centers. The successful treatment strategies included the implantation of covered stents for aortic repair and arterial embolization for pelvic vascular injuries. By sharing these cases, we intend to enhance the understanding of the complex management of such combined - injury situations. We underscore that comprehensive aortic computed tomography angiography (CTA) is of crucial importance in the early detection of aortic injuries and other major vascular injuries in high-energy trauma scenarios. Although regional trauma centers have demonstrated positive impacts on patient outcomes, the retrospective nature of this study and its limited sample size necessitate further large-scale research to validate our findings and proposed management strategies.https://doi.org/10.1186/s13019-025-03391-0Blunt thoracic aortic injuryInternal iliac arteryTraumaPelvic fracture |
| spellingShingle | Lei Wang Huamin Ge Ziyi Wang Haiping Zhao Yufang Zhang Shouyin Jiang Shanxiang Xu Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly Journal of Cardiothoracic Surgery Blunt thoracic aortic injury Internal iliac artery Trauma Pelvic fracture |
| title | Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly |
| title_full | Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly |
| title_fullStr | Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly |
| title_full_unstemmed | Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly |
| title_short | Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly |
| title_sort | multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly |
| topic | Blunt thoracic aortic injury Internal iliac artery Trauma Pelvic fracture |
| url | https://doi.org/10.1186/s13019-025-03391-0 |
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