Advances in diagnosis and treatment of blunt thoracic aortic injury
Blunt thoracic aortic injury(BTAI)is the major cause of morbidity and mortality in trauma patients,with 80％-90％of patients dying immediately at the scene of the accident.Despite rapid advances in the detection and treatment of acute BTAI in recent years,the mortality rate remains high,with a mortality rate of 15％-40％of in-hospital deaths within 24 hours.The mechanism of aortic injury is related to physical impact and drastic changes in hemodynam-ics.For patients who survive the initial injury,maintaining hemodynamic stability in time may prevent injury exacerba-tion.For patients who can reach the hospital,rapid detection and timely and reasonable intervention are crucial.CT angiography can quickly and accurately evaluate the degree of aortic injury and guide the reasonable treatment measures.According to the latest guidelines,the time and method of treatment for grade Ⅰ,Ⅲ and Ⅳ patients have been clearly defined.But repair time in grade Ⅱ patients with BTAI combined with high-risk imaging features is still controversial.Thoracic endovascular aortic repair due to high clinical success rate and low complication rate has become the preferred method for BTAI,but there are still some unavoidable focal problems.This article mainly reviewed the injury mecha-nism,clinical manifestations,imaging diagnosis and treatment of BTAI.
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