Penetrating injuries of the thoracic aorta and brachiocephalic arteries: angiographic findings in 18 cases

Eighteen patients with surgically proved penetrating injuries to the thoracic aorta or brachiocephalic arteries were evaluated preoperatively with angiography. Fifteen injuries resulted from direct penetration of a vessel and three were concussion or blast injuries. Arteriography correctly showed vessel damage in 16 (89%), although one was identified only in retrospect. There were two false-negative examinations. False aneurysms were present in nine. Other findings included occlusion, wall irregularity, and an arterial-arterial fistula. Our results show that angiography is an accurate means of detecting penetrating injuries to the thoracic aorta or brachiocephalic arteries.