Featured Research

from universities, journals, and other organizations

Surgeons Evaluate Treatment Options For Traumatic Aortic Injury, Including Minimally Invasive Technique

Date:
October 20, 2008
Source:
University of Maryland Medical Center
Summary:
A blunt traumatic injury to the aorta is one of the leading causes of death following a vehicle crash. University of Maryland Medical Center surgeons have published a review of treatments for this devastating injury in the the New England Journal of Medicine. The physicians have had success with a minimally invasive technique, which spares patients the trauma of a traditional operation, which involves a large incision in the chest.

A blunt traumatic injury to the aorta, the body's main artery, is one of the leading causes of death following a vehicle crash. If it is not treated rapidly, the patient is at serious risk for artery rupture, which is nearly always fatal. Surgeons from the University of Maryland Medical Center have evaluated various treatments for this type of traumatic aortic injury, including a newer, less invasive procedure that enables them to fix the artery without making an incision.

Their review appears in the October 16, 2008 edition of the New England Journal of Medicine.

"This type of injury to the aorta primarily affects young, healthy people and it has a very high mortality rate. For those who get to medical care quickly, our review found that treatment for blunt aortic injury has evolved and improved considerably," says David G. Neschis, M.D., a vascular surgeon at the University of Maryland Medical Center and the review's lead author. Dr. Neschis is also an associate professor of surgery at the University of Maryland School of Medicine.

"The next step in this evolution will be more widespread use of the minimally invasive treatment that allows us to place a small, tube-like device called an endograft inside of the aorta without making a large incision. It offers tremendous promise as a way to save lives, make recovery easier and limit complications," Dr. Neschis says.

"Trauma patients with this type of aortic injury often have other serious injuries that make traditional surgery risky because it requires opening their chests to repair the problem. A minimally invasive approach in these types of cases can be a valuable life-saving option for these patients," says Thomas M. Scalea, M.D., physician-in-chief at the R Adams Cowley Shock Trauma Center, and professor of surgery and director of the program in trauma at the University of Maryland School of Medicine.

With the traditional method to repair this type of traumatic aortic injury, surgeons would make a large incision to open the chest and then insert a fabric tube, or graft, to make the repair.

"Through our previous experience with traumatic injury patients, we know that the surgical repair could stabilize the injured artery. In this newer technique, we have a different way to deliver the graft, in this case, through the bloodstream," explains Bartley P. Griffith, M.D., chief of cardiac surgery at the University of Maryland Medical Center, and professor and head of the Division of Cardiac Surgery at the University of Maryland School of Medicine.

He adds, "It's extremely gratifying to know that we can now offer a life-saving procedure to patients who would not be good candidates for the open operation."

In the less invasive endograft procedure, doctors insert a catheter into an artery in the leg. Using X-ray guidance, physicians steer the catheter through the blood vessels into the aorta. At the site of the injury, doctors release the endograft, the self-expanding, tube-like device that creates a new lining in the artery.

"The minimally invasive endograft technique provides a way to fix this devastating injury with less blood loss, less operating time and faster recovery time, which can be very important for patients recovering from multiple traumatic injuries," says William Flinn, M.D., head of vascular surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine.

In their review of blunt aortic injury, the University of Maryland physicians also examined the mechanisms of action that cause this type of injury, which can occur with vehicle crashes, collisions, falls and crush injuries. These aortic injuries most likely involve a combination of forces, such as stretching and shearing, which damages the vital artery.

For example, in a car crash, a person traveling at a high rate of speed suddenly stops. Part of the aorta is fixed and stays put, while the mobile part of the artery continues to move. That stress tears the artery. In many cases, the aorta ruptures, killing the person. For those who initially survive, the aorta has been damaged and, almost always, needs to be repaired.

"In trauma care, we are always searching for better ways to help our patients who have complex and immediate medical needs," says Dr. Scalea. "For a trauma patient involved in a crash, the aortic injury will, most likely, not be the only immediate medical problem. There can also be brain swelling, broken bones, spinal cord damage and lung injuries. The option of a less invasive procedure to stabilize the aorta means these patients will not have to undergo the additional trauma of the open operation."

Adds Dr. Neschis, "Our experience with the endograft and our expertise in trauma, cardiac surgery and vascular surgery put the University of Maryland Medical Center in a unique position to use this minimally invasive approach. We have performed 39 of these less invasive aorta repairs in our trauma patients since 2005 with good results. In fact, at our hospital, endovascular repair has supplanted open surgery as the primary treatment option in these cases. We believe this procedure represents the next logical progression in treatment for blunt aortic injury."


Story Source:

The above story is based on materials provided by University of Maryland Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

University of Maryland Medical Center. "Surgeons Evaluate Treatment Options For Traumatic Aortic Injury, Including Minimally Invasive Technique." ScienceDaily. ScienceDaily, 20 October 2008. <www.sciencedaily.com/releases/2008/10/081015183456.htm>.
University of Maryland Medical Center. (2008, October 20). Surgeons Evaluate Treatment Options For Traumatic Aortic Injury, Including Minimally Invasive Technique. ScienceDaily. Retrieved September 21, 2014 from www.sciencedaily.com/releases/2008/10/081015183456.htm
University of Maryland Medical Center. "Surgeons Evaluate Treatment Options For Traumatic Aortic Injury, Including Minimally Invasive Technique." ScienceDaily. www.sciencedaily.com/releases/2008/10/081015183456.htm (accessed September 21, 2014).

Share This



More Health & Medicine News

Sunday, September 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com
Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins