Blunt Trauma to Brachiocephalic Artery: Presentation and Management

Isolated innominate artery injury is very rare and accounts for less than 3% of recognized arterial injuries. Surgical exploration of the artery, especially at the origin of the artery from the arch of the aorta, is surgically challenging. Due to its rarity, any 1 surgeon’s experience in dealing with innominate artery injury is bound to be limited. We report 2 cases of innominate artery injury post-blunt chest trauma. Both patients underwent thoracotomy and innominate artery Dacron graft repair and both had an uneventful postoperative course.

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Innominate artery aneurysm, how to solve it?

Journal of International Medical Research ◽

10.1177/0300060517711087 ◽

2017 ◽

Vol 45 (3) ◽

pp. 1279-1284 ◽

Cited By ~ 4

Author(s):

Xiao-Long Wang ◽

Xin-Liang Guan ◽

Wen-Jian Jiang ◽

Ou Liu ◽

Hong-Jia Zhang

Keyword(s):

Computed Tomography ◽

Computed Tomography Angiography ◽

Work Experience ◽

Median Sternotomy ◽

Artery Aneurysm ◽

Innominate Artery ◽

Ascending Aorta ◽

Dacron Graft ◽

Postoperative Course ◽

The Right

We herein describe our *These authors contributed equally to this work. experience with a congenital innominate artery aneurysm (IAA) that was managed with a simple surgical procedure. A 44-year-old woman was admitted for chest distress. Computed tomography angiography showed a 3.6-cm IAA arising from the aortic arch and compressing the trachea. A median sternotomy was performed with the patient under general anesthesia, and the IAA was found to involve the origin of the innominate artery and the bifurcation of the right subclavian artery and common carotid artery; however, the aorta was intact. An 8-mm Dacron graft was anastomosed to the ascending aorta and distal end of the IAA without cardiopulmonary bypass. The postoperative course was uneventful, and repeat computed tomography angiography revealed no evidence of recurrence 6 months postoperatively. We also herein present a literature review of this rare clinical condition.

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Large Traumatic Pneumatocele in a 2-Year-Old Child

Case Reports in Pediatrics ◽

10.1155/2013/940189 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

N. K. Cheung ◽

A. James ◽

R. Kumar

Keyword(s):

Current Literature ◽

Conservative Management ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Surgical Intervention ◽

Rare Complication ◽

Paediatric Population ◽

Surgical Exploration

Traumatic pneumatoceles are a rare complication of blunt chest trauma in children. Although they characteristically present as small, regular shaped lesions which can be safely treated nonoperatively, larger traumatic pneumatoceles pose diagnostic and management difficulties for clinicians. This case study reports one of the largest traumatic pneumatoceles reported to date in the paediatric population, which resulted in aggressive surgical intervention for both diagnostic and treatment reasons. This case adds further evidence to the current literature that significantly large traumatic pneumatoceles with failure of initial conservative management warrant surgical exploration and management to optimise recovery and prevent complications.

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Combined Tracheal Transection and Innominate Artery Disruption from Blunt Chest Trauma

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(10)62673-2 ◽

1986 ◽

Vol 41 (2) ◽

pp. 213-215 ◽

Cited By ~ 12

Author(s):

Daniel Goldfaden ◽

Paul Seifert ◽

Frank Milloy ◽

Paul Thomas ◽

Sidney Levitsky

Keyword(s):

Blunt Chest Trauma ◽

Chest Trauma ◽

Innominate Artery

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Traumatic Giant Pseudoaneurysm of Innominate Artery

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300416 ◽

2005 ◽

Vol 13 (4) ◽

pp. 369-371 ◽

Cited By ~ 4

Author(s):

Rajinder S Dhaliwal ◽

Suvtesh Luthra ◽

Sameer Goyal ◽

Sukant Behra ◽

Rama Krishna ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Superior Vena ◽

Vena Cava ◽

Innominate Artery ◽

Low Flow ◽

Successful Outcome ◽

Severe Respiratory Distress ◽

Giant Pseudoaneurysm

A 20-year-old man developed a giant pseudoaneurysm of the innominate artery 5 months after blunt chest trauma, causing severe respiratory distress and superior vena cava compression symptoms. The patient was managed with hypothermia and low flow cardiopulmonary bypass resulting in a successful outcome.

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Optical Coherence Tomography Utility in Management of Coronary Artery Injury Due to Blunt Chest Trauma

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2020.09.060 ◽

2020 ◽

Vol 13 (24) ◽

pp. e221-e223

Author(s):

Prince Sethi ◽

Enrique Campos ◽

Mark Reichuber ◽

Jeffrey Kramer ◽

Eric Hockstad ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Coronary Artery ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Optical Coherence ◽

Artery Injury ◽

Coronary Artery Injury

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Internal Mammary Artery Injury, Anterior Mediastinal Hematoma, and Cardiac Compromise after Blunt Chest Trauma

The Journal of Trauma: Injury, Infection, and Critical Care ◽

10.1097/00005373-199511000-00038 ◽

1995 ◽

Vol 39 (5) ◽

pp. 1018-1021 ◽

Cited By ~ 23

Author(s):

Isaias Irgau ◽

Gerard J. Fulda ◽

Dalva Hailstone ◽

Glen H. Tinkoff

Keyword(s):

Blunt Chest Trauma ◽

Internal Mammary Artery ◽

Chest Trauma ◽

Mediastinal Hematoma ◽

Artery Injury ◽

Internal Mammary ◽

Internal Mammary Artery Injury

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Comparison of Multiplane Transesophageal Echocardiography and Contrast-enhanced Helical CT in the Diagnosis of Blunt Traumatic Cardiovascular Injuries

Anesthesiology ◽

10.1097/00000542-200104000-00015 ◽

2001 ◽

Vol 94 (4) ◽

pp. 615-622 ◽

Cited By ~ 77

Author(s):

Philippe Vignon ◽

Marie-Paule Boncoeur ◽

Bruno François ◽

Geoffray Rambaud ◽

Antoine Maubon ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Transesophageal Echocardiography ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Injury Severity ◽

Innominate Artery ◽

Helical Ct ◽

Aortic Injury ◽

Helical Computed Tomography ◽

Aortic Isthmus

Background Multiplane transesophageal echocardiography (TEE) and helical computed tomography (CT) of the chest have been validated separately against aortography for the diagnosis of acute traumatic aortic injuries (ATAI). However, their respective diagnostic accuracy in identifying blunt traumatic cardiovascular lesions has not been compared. Methods During a 3-yr period, 110 consecutive patients with severe blunt chest trauma (age: 41 +/- 17 yr; injury severity score: 34 +/- 14) prospectively underwent TEE and chest CT as part of their initial evaluation. Results of both imaging methods were interpreted independently by experienced investigators and subsequently compared. All cases of subadventitial acute traumatic aortic injury were surgically confirmed. Results Seventeen patients had vascular injury and 11 had cardiac lesions. TEE and CT identified all subadventitial disruptions involving the aortic isthmus (n = 10) or the ascending aorta (n = 1) that necessitated surgical repair. In contrast, CT only depicted one disruption of the innominate artery. TEE detected injuries involving the intimal or medial layer, or both, of the aortic isthmus in four patients with apparently normal CT results who underwent successful conservative treatment. All cardiac injuries but two were identified only by TEE. Conclusions In patients with severe blunt chest trauma, TEE and CT have similar diagnostic accuracy for the identification of surgical acute traumatic aortic injuy. TEE also allows the diagnosis of associated cardiac injuries and is more sensitive than CT for the identification of intimal or medial lesions of the thoracic aorta.

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