Pediatric aortic trauma: A review of the literature.

Abstract

The patterns of pediatric aortic injury have changed and the incidence of penetrating aortic trauma, secondary to ballistic injuries, is increasing. Patterns of treatment have also changed, with fewer open aortic repairs as more endovascular technologies evolve and are able to be applied to the pediatric population. This is a review of the current available literature regarding pediatric aortic injury both penetrating and blunt in the abdominal and thoracic aorta. When comparing thoracic aortic injuries (TAIs) to abdominal aortic injuries (AAIs), TAI is associated with higher mortality rates. Overall, blunt injuries are more common than penetrating injuries, and there are higher mortality rates associated with penetrating mechanisms. Improvements in endovascular repair have facilitated improved outcomes and survival rates for blunt TAIs. Compared with blunt TAIs, blunt AAIs are more rare, and open repair is the mainstay of treatment in symptomatic or life-threatening cases. Much of the data regarding the management of pediatric aortic injuries comes from limited series and case reports. Future research efforts should aim at tracking these repairs, their outcomes, and technical pitfalls to serve as a foundation for future guidelines.