Diagnostic imaging and management of blunt injury of thoracic aorta

Abstract

           Blunt thoracic aortic injury infrequently occurs in trauma patients but has high mortality rate. More than 80% of patients who sustain an aortic injury from blunt trauma die before reaching the hospital. Of the remaining survivors, 50% die within 24 hours if they do not receive proper management. Since clinical symptoms of the patients are neither sensitive nor specific for the diagnosis of thoracic aortic injury, radiologic imaging plays an important role in the diagnosis and management. In the era of advanced imaging technologies, multidetector computed tomography (MDCT) provides not only high sensitivity in detecting aortic injury, but also high diagnostic accuracy. Treatment strategies for thoracic aortic injury including open surgical repair, endovascular stent-graft repair, and medical management, are selected depending mainly on the imaging findings. In this study, the diagnostic imaging and management of blunt thoracic aortic injury as well as minimal aortic injury (MAI) and chronic traumatic pseudoaneurysm are reviewed.