List Archives

Thu Oct 18 16:13:41 BST 2007

Ken, I still don't see what is the problem?

In order to place the stent-graft into the aortic lumen at the right
position, we always perform an aortogram to assist in the decision where
exactly the injury to the aortic wall is, at the beginning of the procedure.
If this reveals that the diagnosis of the CT-Angio was wrong, the procedure
is aborted.  So, in essence, what we are left with is the "official"
aortogram that you preach for all along.  The CT, then becomes a "Screening"
procedure that is backed by an official aortogram prior to the actual
placement of the stent-graft.

As I mentioned before, not that we had that many cases, but there was not
even one that the formal aortogram, prior to placement of the stent-graft,
proved the CT-Angio to be wrong.

The only problem will be that the CT-Angio will miss an injury that can show
up with a formal angiogram.  This is less likely now that we have the 64
slice spiral CT.  The views are much clearer, and the chance of a false
negative lesion (Compared to formal angiography) is much less than a false
positive one.

What's wrong with this logic?  Where am I wrong?

Mickey Stein

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: Thursday, October 18, 2007 4:55 AM
To: trauma-list at trauma.org
Subject: Re: Traumatic aortic transections and stents

Thanks Sal,   I was beginning to think I was out there all  alone.    I
tried 
hard to see if I could make this out to a  patient with a Diverticulum of 
Kummeral, producing a dysphasia lucoria, but I  could not for sure.    Most 
trauma surgeons do not even know of  this arch anomaly or any of the other
such 
lesions which can cause real  headaches for the interventionalist, be it 
radiologist or surgeon.  

k

************************************** See what's new at http://www.aol.com
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

List Archives

For your convenience, find the Trauma List Archive Below

Traumatic aortic transections and stents