Angiography of intimal and intramural arterial injuries

Fifteen patients with injuries disrupting the tunica intima and media are reviewed and 5 cases demonstrating the typical angiographic appearance of these injuries described. In all 15, the tunica adventitia remained intact and pulses were present on the initial physical examination. Injuries described include subintimal hemorrhages with and without an associated tear of the intima and a complete tear of both the tunica intima and media with the tunica adventitia intact. The authors conclude that angiography is the best preoperative diagnostic procedure for these injuries; it should be used whenever the trauma involves a site near a major vessel.