ABSTRACT
Depending on the extent, location, and severity of the trauma, any blood vessel in the chest or abdomen or any combination thereof may be involved in some type of vascular injury. Partial tears, transmural tears, and contusion without tears may contribute to hemorrhage, thrombosis, vasculitus, aneurysm, and pseudoaneurysm formation. Compression and deceleration forces similar to those producing direct or indirect cardiac injury are involved. The most frequent vessel involved is the aorta. Venous structures are less commonly involved. Injuries to the thoracic aorta are the commonest great vessel blunt injury. The innominate, subclavian, or carotid arteries may be involved, as well as the superior vena cava. The commonest site of rupture is the area of the aortic isthmus, just distal to the origin of the left subclavian artery. The most common site involved is the ascending aorta, and in these patients concomitant cardiac injury commonly occurs. Probably fewer than 20% of patients survive aortic rupture, and those that survive surgical correction are frequently left with comorbid conditions, including varying degrees of cerebral dysfunction. The preinjury status of a patient’s cerebral function is a definite contributing factor to the end result, which is usually influenced by the degree and duration of the shock syndrome with its accompanying decrease in cerebral perfusion.
