{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T04:06:56Z","timestamp":1773115616444,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Blunt traumatic aortic injury (BTAI) is a potentially fatal condition, typically resulting from high-velocity trauma. To date, little is known about this type of injury among skiers, who form the largest patient cohort with aortic injuries in the alpine region of Tyrol, Austria. Methods: This retrospective, single-center study at the University Hospital of Innsbruck analyzed patients who underwent endovascular treatment for blunt traumatic aortic injury from 2005 to 2023. Patient data were extracted from electronic and digitalized medical history records. Subsequent analyses compared the baseline characteristics and clinical results of the skiing accident (SA) group to the motor vehicle accident (MVA) group. Results: A total of 48 BTAI patients receiving TEVAR were included, 25 (52%) from SAs versus 23 (48%) from MVAs, who were predominantly male (92% vs. 78.3%). Despite similar preoperative risk profiles and ASA Scores (1.44 vs. 1.74) and no marked differences in BTAI injury grades or the affected aortic zones, significant disparities emerged: the SA group experienced shorter median ICU stays (3 vs. 11 days, p = 0.0007), fewer concomitant injuries (5 vs. 7, p = 0.005), and lower Injury Severity Scores (ISSs) (29 vs. 33, p = 0.003) than their MVA counterparts. The presence of rib fractures alongside other thoracic injuries, such as lung injury, pneumothorax, or hemothorax, was strongly correlated with BTAI in patients following skiing accidents (OR = 128.5). Conclusions: The injury severities and locations of BTAI in SA patients were comparable to those in MVA patients, indicating similar mechanisms of thoracic trauma. However, the SA patients experienced fewer concurrent pelvic and extremity fractures, had less post-procedural morbidity, and required shorter ICU stays. The presence of rib fractures combined with other thoracic injuries strongly suggests BTAI. These indicators should lead to prompt imaging and appropriate therapy.<\/jats:p>","DOI":"10.3390\/jcm13113315","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T07:39:49Z","timestamp":1717486789000},"page":"3315","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Beyond the Slopes and Highways: Endovascular Repair of Blunt Traumatic Aortic Injuries after Skiing versus Motor Vehicle Accidents"],"prefix":"10.3390","volume":"13","author":[{"given":"David","family":"Wippel","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8141-8006","authenticated-orcid":false,"given":"Maximilian","family":"Lutz","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Kluckner","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonhard","family":"Gruber","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-2309","authenticated-orcid":false,"given":"Alexander","family":"Loizides","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elke R.","family":"Gizewski","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7200-4145","authenticated-orcid":false,"given":"Florian K.","family":"Enzmann","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Wipper","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMra0706159","article-title":"Blunt aortic injury","volume":"359","author":"Neschis","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_2","unstructured":"Selim, S., and Burhan Hakan, K. (2021). Trauma and Emergency Surgery, IntechOpen. Chapter 3."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/TA.0b013e3181df68b3","article-title":"Blunt thoracic aortic injuries: An autopsy study","volume":"70","author":"Teixeira","year":"2011","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/00005373-199703000-00003","article-title":"Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma","volume":"42","author":"Fabian","year":"1997","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jvs.2016.02.047","article-title":"Call for a new classification system and treatment strategy in blunt aortic injury","volume":"64","author":"Heneghan","year":"2016","journal-title":"J. Vasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.jvs.2022.12.026","article-title":"Males and females have similar mortality after thoracic endovascular aortic repair for blunt thoracic aortic injury","volume":"77","author":"Rastogi","year":"2023","journal-title":"J. Vasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1097\/00005373-200006000-00003","article-title":"Identification of Trauma Patients at Risk of Thoracic Aortic Tear by Mechanism of Injury","volume":"48","author":"Horton","year":"2000","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jvs.2010.08.027","article-title":"Endovascular repair of traumatic thoracic aortic injury: Clinical practice guidelines of the Society for Vascular Surgery","volume":"53","author":"Lee","year":"2011","journal-title":"J. Vasc. Surg."},{"key":"ref_9","unstructured":"Graph (2023, December 13). Anzahl der \u00dcbernachtungen von G\u00e4sten in Beherbergungen in \u00d6sterreich nach Saisons von 2012\/2013 bis 2022\/2023 (in Millionen) Statista: Statistik Austria. Available online: https:\/\/de.statista.com\/statistik\/daten\/studie\/295500\/umfrage\/verteilung-der-uebernachtungen-in-oesterreich-nach-herkunftslaendern\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1249\/JSR.0000000000000651","article-title":"Common Skiing and Snowboarding Injuries","volume":"18","author":"Weinstein","year":"2019","journal-title":"Curr. Sports Med. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.5435\/JAAOS-D-16-00832","article-title":"Comprehensive Review of Skiing and Snowboarding Injuries","volume":"26","author":"Owens","year":"2018","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110830","DOI":"10.1016\/j.injury.2023.05.061","article-title":"Incidence of alpine skiing and snowboarding injuries","volume":"54","author":"Wagner","year":"2023","journal-title":"Injury"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1136\/bjsm.2009.068767","article-title":"Injuries about the shoulder in skiing and snowboarding","volume":"43","author":"McCall","year":"2009","journal-title":"Br. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1097\/01.ta.0000228878.09533.99","article-title":"Aortic rupture in high-speed skiing crashes","volume":"61","author":"Heller","year":"2006","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s13019-017-0667-4","article-title":"Open stent graft repair with upper-half Sternotomy for blunt thoracic aortic injury: A case report","volume":"12","author":"Komatsu","year":"2017","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s00113-012-2320-y","article-title":"Traumatic aortic rupture and concomitant type B aortic dissection after skiing accident","volume":"117","author":"Jost","year":"2014","journal-title":"Unfallchirurg"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.avsg.2016.07.089","article-title":"Functional Assessment and Evaluation of Outcome After Endovascular Therapy with Coverage of the Left Subclavian Artery in Case of Blunt Thoracic Aortic Injury","volume":"40","author":"Gombert","year":"2017","journal-title":"Ann. Vasc. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Schachner, T., Fischler, N., Dumfarth, J., Bonaros, N., Krapf, C., Schobersberger, W., and Grimm, M. (2013). Aortic dissection type A in alpine skiers. BioMed Res. Int., 2013.","DOI":"10.1155\/2013\/192459"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/j.jvs.2009.02.234","article-title":"Blunt traumatic aortic injury: Initial experience with endovascular repair","volume":"49","author":"Azizzadeh","year":"2009","journal-title":"J. Vasc. Surg."},{"key":"ref_20","unstructured":"Gennarelli, T.A., Wodzin, E., and Association for the Advancement of Automotive Medicine (2008). Abbreviated Injury Scale 2005: Update 2008, Association for the Advancement of Automotive Medicine."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Harris, P.A., Taylor, R., Minor, B.L., Elliott, V., Fernandez, M., O\u2019Neal, L., McLeod, L., Delacqua, G., Delacqua, F., and Kirby, J. (2019). The REDCap consortium: Building an international community of software platform partners. J. Biomed. Inform., 95.","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jvs.2010.07.008","article-title":"Reporting standards for thoracic endovascular aortic repair (TEVAR)","volume":"52","author":"Fillinger","year":"2010","journal-title":"J. Vasc. Surg."},{"key":"ref_24","unstructured":"Asensio, J.A., and Trunkey, D.D. (2008). Current Therapy of Trauma and Surgical Critical Care, Mosby."},{"key":"ref_25","first-page":"6547849","article-title":"ICU Length of Stay and Factors Associated with Longer Stay of Major Trauma Patients with Multiple Rib Fractures: A Retrospective Observational Study","volume":"2022","author":"Abdelwahed","year":"2022","journal-title":"Crit. Care Res. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5453624","DOI":"10.1155\/2019\/5453624","article-title":"Comparison of Injury Severity Score, Glasgow Coma Scale, and Revised Trauma Score in Predicting the Mortality and Prolonged ICU Stay of Traumatic Young Children: A Cross-Sectional Retrospective Study","volume":"2019","author":"Huang","year":"2019","journal-title":"Emerg. Med. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.injury.2004.09.039","article-title":"The Injury Severity Score or the New Injury Severity Score for predicting intensive care unit admission and hospital length of stay?","volume":"36","author":"Lavoie","year":"2005","journal-title":"Injury"},{"key":"ref_28","first-page":"1416","article-title":"A comparison of mortality predictive abilities between NISS and ISS in trauma patients","volume":"84","author":"Jamulitrat","year":"2001","journal-title":"J. Med. Assoc. Thail."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/01.TA.0000085721.47738.BD","article-title":"The worst injury predicts mortality outcome the best: Rethinking the role of multiple injuries in trauma outcome scoring","volume":"55","author":"Kilgo","year":"2003","journal-title":"J. Trauma Acute Care Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3315\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:53:33Z","timestamp":1760108013000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,4]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13113315"],"URL":"https:\/\/doi.org\/10.3390\/jcm13113315","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,4]]}}}