title: [The importance of CT angiography for screening supra-aortic vascular damage in severely injured patients].
abstract: OBJECTIVE
  Traumatic injury of supra-aortic vessels remains a challenge in the initial diagnostics of severely injured patients. The presented prospective study analyzed the impact of multislice computed tomography angiography (CTA) as the primary diagnostic method.
  
  
  METHODS
  Patients with the following criteria were included and screened for a dissection of the supra-aortic vessels: a) admission directly from the scene, b) resuscitation room treatment indicated by the official criteria of the DGU (German Society for the Surgery of Trauma), c) suspected blunt trauma to head or trunk as well as d) age over 16 years.
  
  
  RESULTS
  During a period of 18 months 374 patients were treated for blunt trauma in the resuscitation room. In 176 cases CTA of the supra-aortic vessels was performed and pathological findings were observed in 16 patients. In 4 cases (2%) a traumatic dissection of supra-aortal vessels was diagnosed and confirmed by magnetic resonance imaging (MRI). All patients received heparin in a PTT effective dosage for 2 weeks and after rehabilitation there were no neurologic deficits.
  
  
  CONCLUSIONS
  Traumatic supra-aortic dissection was found in 2% of cases in the presented study group. The mechanisms of injury were not distinct in this group. Essentially MSCT angiography screening was demonstrated to be a safe diagnostic tool.
authors.affiliation: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Giessen und Marburg, Standort Marburg, Baldingerstr., 35043 Marburg. zettl@med.uni-marburg.de
authors.forename: R P
authors.initials: RP
authors.lastname: Zettl
authors.forename: C A
authors.initials: CA
authors.lastname: Kühne
authors.forename: M
authors.initials: M
authors.lastname: Kalinowski
authors.forename: M
authors.initials: M
authors.lastname: Kray
authors.forename: H
authors.initials: H
authors.lastname: Kühl
authors.forename: S
authors.initials: S
authors.lastname: Asgari
authors.forename: D
authors.initials: D
authors.lastname: Nast-Kolb
authors.forename: S
authors.initials: S
authors.lastname: Ruchholtz
mesh_terms: D000792:Angiography / Q000706:statistics & numerical data*; D001011:Aorta / Q000293:injuries*; D001027:Aortography / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000453:epidemiology
references.citation: Unfallchirurg. 2001 Oct;104(10):927-37
references.pmid: 11699302
references.citation: Nervenarzt. 2006 Sep;77 Suppl 1:S17-29; quiz S30
references.pmid: 16897046
references.citation: Rofo. 2007 Feb;179(2):119-29
references.pmid: 17310443
references.citation: Dtsch Arztebl Int. 2008 Mar;105(13):225-31
references.pmid: 19629200
references.citation: Unfallchirurg. 2003 May;106(5):380-6
references.pmid: 12750811
references.citation: Radiologe. 1996 Nov;36(11):850-4
references.pmid: 9036425
references.citation: Unfallchirurg. 2006 Nov;109(11):964-74; discussion 975-6
references.pmid: 17058060
references.citation: Ann Surg. 1998 Oct;228(4):462-70
references.pmid: 9790336
references.citation: Am J Surg. 2005 Dec;190(6):845-9
references.pmid: 16307932
references.citation: J Trauma. 2006 May;60(5):925-9; discussion 929
references.pmid: 16688051
references.citation: J Trauma. 2004 Jul;57(1):11-7; discussion 17-9
references.pmid: 15284541