Management of Blunt Thoracic Aortic Injury in Polytrauma Patients: A Review of Clinical Outcomes and Intervention Strategies.

Blunt thoracic aortic injury (BTAI) is a life-threatening condition most commonly resulting from high-energy trauma, such as motor vehicle accidents. It is frequently associated with polytrauma, which complicates clinical decision-making and the timing of surgical intervention. This systematic review aimed to evaluate the effectiveness, safety, and outcomes of different management strategies, particularly thoracic endovascular aortic repair (TEVAR), in patients with BTAI and concurrent polytrauma. A comprehensive search was conducted across five major databases, PubMed, Embase, Scopus, Web of Science, and the Cochrane Library per PRISMA guidelines, identifying 378 records. Five studies were included after screening and eligibility assessment, comprising clinical trials, cohort studies, and narrative reviews. The results consistently favored TEVAR over open repair, demonstrating high technical success, lower perioperative morbidity, and reduced mortality, especially when intervention was appropriately timed. The review also highlighted the influence of injury severity, hemodynamic stability, and technological advancements on treatment selection and outcomes. While TEVAR has emerged as the preferred approach in modern trauma care, gaps in comparative long-term data and standardized protocols persist. Further prospective multicenter studies are recommended to strengthen the evidence base and refine clinical guidelines.