Angiographic description of blunt traumatic injuries to the thoracic aorta with specific relevance to endograft repair.
OBJECTIVE
To describe the precise anatomical location and extent of injury (based on angiography) in a series of patients with blunt thoracic aortic injury (BTAI) and evaluate the findings relative to the potential for endograft repair.


METHODS
Thoracic aortograms from 50 trauma patients (37 men; mean age 37 years, range 13-87) with BTAI were retrospectively reviewed. Parameters important for endograft repair were recorded, including the length of the pseudoaneurysm, the distance between the origin of the most distal arch vessel and the pseudoaneurysm, the diameter of the aorta both above and below the pseudoaneurysm, and finally, the curvature of the aorta in the vicinity of the pseudoaneurysm.


RESULTS
The mean distance from the left subclavian artery to the superior aspect of the injury measured 5.8 mm along the lesser curve and 14.9 mm along the greater curve. The mean length of the injury was 17.0 mm and 26.0 mm along the lesser and greater curves, respectively. The mean aortic diameter adjacent to the injury measured 19.3 mm. The mean degree of curvature of the aorta over the length of the injury was 27.2 degrees, with a mean radius of curvature of 32.6 mm at the superior aspect of the injury and 39.3 mm inferiorly.


CONCLUSIONS
In most cases of BTAI, the location of the injury will necessitate covering the origin of the left subclavian artery if endovascular repair is to be performed. The curvature of the aorta in the region predisposed to these injuries requires that the endograft be very flexible and/or precurved.
Borsa
John J
JJ
Department of Radiology, University of Washington Medical Center, Seattle 98195, USA. jjborsa@u.washington.edu
Hoffer
Eric K
EK
Karmy-Jones
Ryad
R
Fontaine
Arthur B
AB
Bloch
Robert D
RD
Yoon
Justin K
JK
So
Coralli R
CR
Meissner
Mark H
MH
Demirer
Seher
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000293:injuries*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D012189:Retrospective Studies; D015607:Stents; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*