Occult mediastinal great vessel trauma: the value of aortography performed during angiographic screening for blunt cervical vascular trauma.
OBJECTIVE
To determine the value of aortography in the assessment of occult aortic and great vessel injuries when routinely performed during screening angiography for blunt cerebrovascular injury (BCVI).


METHODS
One hundred and one consecutive patients who received both aortography and screening four-vessel angiography over 4 years were identified retrospectively. Angiograms for these patients were evaluated, and the incidence of occult mediastinal vascular injury was determined.


RESULTS
Of the 101 patients, 6 (6%) had angiographically documented traumatic aortic injuries. Of these 6 patients, one injury (17%) was unsuspected prior to angiography. Four of the 6 (67%) also had BCVI. One additional patient also had an injury to a branch of the subclavian artery.


CONCLUSIONS
Routine aortography during screening angiography for BCVI is not warranted due to the low incidence (1%) of occult mediastinal arterial injury. However, in the setting of a BCVI screening study and no CT scan of the chest, aortography may be advantageous.
Ray
Charles E
CE
Department of Interventional Radiology, Denver Health Medical Center, Denver, Colorado, USA. cray@dhha.org
Bauer
Jason R
JR
Cothren
C Clay
CC
Turner
James H
JH
Moore
Ernest E
EE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001013:Aorta, Thoracic / Q000293:injuries*; D001027:Aortography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000098:blood supply* / Q000293:injuries*; D008875:Middle Aged; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*