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Thoracic aortography following blunt chest trauma
J T Sturm1, D G Hankins, G Young
1Department of Emergency Medicine, St Paul-Ramsey Medical Center, MN.
The American Journal of Emergency Medicine
|March 1, 1990
Summary
Thoracic aortography is a safe and accurate diagnostic tool for identifying cardiovascular injuries in patients with blunt chest trauma. This study found it effective in detecting conditions like aortic rupture and subclavian artery disruption.
Area of Science:
- Cardiovascular Surgery
- Diagnostic Imaging
- Trauma Surgery
Background:
- Blunt chest trauma can cause life-threatening cardiovascular injuries.
- Accurate and timely diagnosis is crucial for patient outcomes.
- Thoracic aortography has been used to evaluate these injuries.
Purpose of the Study:
- To evaluate the accuracy and safety of thoracic aortography in patients with blunt chest trauma.
- To determine the incidence of cardiovascular injuries diagnosed via aortography.
Main Methods:
- Retrospective review of 314 patients undergoing thoracic aortography after blunt chest trauma (1968-1986).
- Analysis of aortogram findings, patient demographics, injury mechanisms, and complications.
Main Results:
- Thoracic aortography identified cardiovascular injuries in 19.7% of cases, including aortic rupture (47 patients) and subclavian artery disruption (15 patients).
- The procedure had a low complication rate (1.7%), with no treatment-required complications.
- Aortography demonstrated high accuracy with no false-negative results.
Conclusions:
- Thoracic aortography is an accurate and safe imaging modality for diagnosing blunt traumatic cardiovascular injuries.
- Widened mediastinum on chest roentgenogram was the primary indication for the procedure.