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Blunt injuries to the aortic arch vessels
J M Rosenberg1, C E Bredenberg, M A Marvasti
1Department of Surgery, State University of New York Health Science Center, Syracuse.
The Annals of Thoracic Surgery
|October 1, 1989
Summary
Blunt trauma to the aortic arch
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Thoracic Surgery
Background:
- Blunt trauma to the brachiocephalic branches of the aortic arch is rare.
- This study reports the largest series to date of such injuries.
Purpose of the Study:
- To describe the largest series of blunt injuries to the brachiocephalic branches of the aortic arch.
- To detail injury mechanisms, associated injuries, diagnostic findings, surgical approaches, and outcomes.
Main Methods:
- Retrospective review of 30 patients with 33 vascular injuries.
- All patients underwent angiography for diagnosis.
- Surgical management was tailored to injury site and vascular control needs.
Main Results:
- Innominate artery was most commonly injured (50%), followed by common carotid and subclavian arteries (25% each).
- Associated injuries included head trauma, hemopneumothorax, and brachioplexus injuries.
- Twenty-seven patients survived 6 months to 10 years; 18/20 vascular reconstructions remained patent.
- No return of neurological function was observed in patients with brachioplexus injuries.
Conclusions:
- Blunt aortic arch branch injuries require diverse surgical strategies.
- Vascular reconstruction offers favorable long-term patency.
- Brachioplexus injuries associated with these traumas have poor neurological recovery prognosis.