Injuries to the aorta caused by blunt chest traumas range from lacerations involving the tunica intima of the vessel to complete rupture of the vessel wall, 7, 8 and the portion most often injured is at the ligamentum arteriosum, a section immediately distal of the left subclavian artery, which is a region of transition between the aortic arch (relatively mobile) and the descending aorta (more fixed). 4, 5 Endovascular treatment has become the first-choice method for hemodynamically stable patients with thoracic aorta injuries caused by blunt trauma and is associated with lower mortality rates when compared with conventional surgical treatment. This has occurred thanks to development of pre-hospital systems, training of emergency teams, expansion of diagnostic resources, such as computed tomography (CT), and endovascular methods. 1Ĭonsiderable advances have been achieved over the last 20 years in the treatment of patients who remain alive long enough to be treated in hospital. 5 Conventional surgical treatment can involve addition risk for multiple trauma victims and, in view of this, endovascular treatment offers a promising alternative approach for treating blunt trauma injuries involving the thoracic aorta. The majority of blunt thoracic aorta trauma victims are young adults of working age, presenting with involvement of multiple systems, 1 with injuries primarily concentrated in the head, abdominal area, and/or lower limbs. 3 This type of injury is involved in one third of deaths caused by automobile collisions.
1, 2 The main risk factor for thoracic aorta injury in blunt trauma cases is sudden deceleration, and the most prevalent trauma mechanisms are automobile collisions (70%), motorcycle accidents, falls from height, and being run over.
Blunt thoracic aortic trauma is the second most common cause of death of trauma patients, with a pre-hospital mortality rate of 80%, second only to head trauma.