Advances in the management of blunt thoracic aortic injury: Parmley to the present

Timothy C. Fabian

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

This article traces the evolution in management of blunt aortic injury (BAI) over the past 50 years from the time of the seminal description from Parmley in 1958. There have been major advances in both diagnostics and treatment paradigms with very rapid technologic advances occurring over the past decade. For many years, conventional aortography was the principle diagnostic tool, but it has been replaced by the progression of CT. The widespread adoption of antihypertensive therapy has sharply reduced the incidence of aortic rupture before planned reconstruction. Many patients with major associated injuries have definitive treatment of BAI managed in a delayed fashion with the use of hypertensives, which appears to improve outcomes. In the past 5 years, definitive treatment has changed with the majority of injuries being treated today with endoluminal stent grafts as opposed to open thoracotomy and traditional repair techniques. Paraplegia rates have diminished from 8 to 10 per cent down to 1 to 2 per cent in association with these therapeutic advances.

Original languageEnglish (US)
Pages (from-to)273-278
Number of pages6
JournalAmerican Surgeon
Volume75
Issue number4
StatePublished - Apr 2009

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Thoracic Injuries
Nonpenetrating Wounds
Therapeutics
Aortography
Aortic Rupture
Paraplegia
Wounds and Injuries
Thoracotomy
Antihypertensive Agents
Stents
Transplants
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Medicine(all)

Cite this

Advances in the management of blunt thoracic aortic injury : Parmley to the present. / Fabian, Timothy C.

In: American Surgeon, Vol. 75, No. 4, 04.2009, p. 273-278.

Research output: Contribution to journalArticle

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