Serial aortography assesses stability of "atypical" aortic arch ruptures

The victim of a high speed motor vehicle accident sustained an ascending aortic laceration as well as avulsion of the left subclavian artery. Initial management of the tears was conservative. The case is typical of "atypical" aortic arch tears except that the patient survived without emergent surgery. Serial aortography proved useful in assessing stability of the tears, providing opportunity to observe the natural history of these injuries angiographically. The distribution of aortic arch injuries following blunt trauma is reviewed.