Thoracic aortic rupture: advantages of intraarterial digital subtraction angiography

Sixty-one consecutive patients with blunt thoracic trauma underwent intraarterial digital subtraction angiography (IA-DSA) of the thoracic aorta because of obscuration of the aortic knob or mediastinal widening on chest radiographs. Ten of these patients had aortic ruptures diagnosed by IA-DSA. Digital subtraction aortography proved 100% accurate as indicated by results of surgery, conventional arteriography, serial chest radiography, and clinical follow-up. The method was 50% faster compared with conventional aortography and saved significantly on film costs. The potential for use of smaller caliber catheters and a decrease in contrast requirements also make this method safer than conventional arteriography. We recommend IA-DSA as the procedure of choice when emergency aortography is warranted.