The Isolated Posttraumatic Aneurysm of the Brachiocephalic Artery After Blunt Thoracic Contusion

Kraus, Thomas; Paetz, Burkhard; Richter, Göb M.; Allenberg, J.R

doi:10.1007/bf02000254

Cited by 23 publications

(17 citation statements)

References 26 publications

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“… 4 In particular, IAAs are more liable to rupture when the diameter exceeds 3 cm. 4 , 5 Since 1844, approximately 120 cases of IAA have been reported in the literature ( Table 1 ). Three types of IAA have been described based on the extent of involvement of the innominate artery origin and aorta ( Table 2 ): (A) no involvement of the origin of the innominate artery, (B) involvement of the origin of the innominate artery but not of the aorta, and (C) involvement of both the innominate artery and aorta.…”

Section: Discussionmentioning

confidence: 99%

Innominate artery aneurysm, how to solve it?

et al. 2017

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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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Section: Discussionmentioning

confidence: 99%

Innominate artery aneurysm, how to solve it?

et al. 2017

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“…[1][2][3][4] The incidence of reported vessel injuries after blunt chest traumas has increased during the last two decades, probably because of improved diagnostic means. Coronary artery injury resulting from blunt chest trauma most often affects the left anterior descending artery and usually results from frontal impact motor vehicle crashes.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Carotid Rupture and Coronary Dissection After Blunt Chest Trauma

Pawlik

Kuenzig²,

Holmer³

et al. 2007

Journal of Trauma: Injury, Infection &Amp; Critical Care

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T his case report illustrates the importance of diagnostic measures of supraaortal vessels after blunt chest trauma. A high index of suspicion should be maintained in the posttraumatic period to detect injuries of carotid vessels as early as possible, especially in the anesthetized patient.Traumatic arterial dissections are relatively rare incidents. Reviewing the literature revealed only 14 cases of traumatic coronary artery dissections that have been described within the last two decades. Traumatic lesions of the carotids are more frequent. Nevertheless, to the best of our knowledge no case of simultaneous traumatic coronary and carotid rupture has been described until now. We report a case of a 21-year-old man suffering from both coronary dissection and carotid rupture after a frontal impact car crash. Case HistoryA 21-year-old male automobile driver had a frontal crash against a tree. His seatbelt was not fastened at the time of crash and the airbag on the driver's side had not inflated. On arrival of the emergency physician, the Glasgow Coma Scale (GCS) score at the scene was 12 and quickly improved to 15 ten minutes later. Except for a slight disorientation he was fully awake and showed no neurologic abnormalities. Oxygen saturation and arterial blood pressure were in the normal range throughout the emergency treatment and during the hospital transport. Mild sedation with 7 mg of midazolam was administered to reduce restlessness during transport. For volume resuscitation, a total of 1,000 mL colloids and 1,500 mL of crystalloids was infused.After 1 hour, the patient reached the emergency department having stable vital signs. Because of agitation and a presumed thoracic trauma, he was anesthetized and mechanically ventilated. While inserting a central venous line ventricular fibrillation occurred and was reconverted to sinus rhythm by a single 200-J electric shock. After this incident vasopressor treatment (0.4 mg/h of norepinephrine) was needed for circulatory stabilization. The thoracic computed tomography (CT) scan exhibited a bilateral lung contusion and a mediastinal hematoma. A right-sided pneumothorax was subsequently drained by a thoracic tube. The cranial CT showed minimal frontal contusions and a left ocular injury consisting of glass-splinter impact, retro bulb hematoma, and orbital fracture. The abdominal scan displayed no pathologic finding. Because of the eyeball lesion, he was brought to our university hospital by helicopter 8 hours after the crash for ophthalmologic treatment.The electrocardiogram at admission in the emergency room showed ST segment-elevations in V 3 to V 5 and a loss of the R-wave in V 2 to V 6 ( Fig. 1). At this time, the myocardial isoenzyme of creatinine kinase (CK-MB) was already elevated to 97.7 U/L with a total creatinine kinase (CK) of 768 U/L. Troponin I was raised to 7.65 ng/mL. Transthoracic echocardiography revealed both an anteroseptal hypokinesia and a septal akinesia. Coronary angiography showed an occlusive dissection of the proximal left anterior descending a...

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“…Blunt injury of the thoracic aorta is frequently lethal and the majority of patients with major vascular injuries of the thoracic outlet die from massive hemorrhage long before they reach the hospital [24,26,27,28]. Although brachiocephalic injuries are rare, they represent the most frequently injured branch of the aortic arch [30].…”

Section: Discussionmentioning

confidence: 99%

“…Occurrence of pseudoaneurysms at the origin of the brachiocephalic artery are rare [6,8,11,15,16,17,22,23,24,25,26,27,28,29]. We describe a patient with a deceleration injury who sustained a traumatic pseudoaneurysm located at the base of the brachiocephalic artery.…”

Section: Introductionmentioning

confidence: 99%

Acute traumatic tear of the base of the brachiocephalic artery after blunt trauma: report of a rare case and review of the literature

Cirillo

McDermott

Crummy

2001

Emergency Radiology

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This report describes a patient who presented to our institution after a high-speed motor vehicle accident with an abnormal superior mediastinum as shown on supine chest radiograph. Helical computed tomographic aortography and thoracic aortography revealed the patient to have a pseudoaneurysm in a rarely encountered site, in the anterolateral region of the right brachiocephalic artery. The imaging features of this case and the relevant literature are reviewed.

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The Isolated Posttraumatic Aneurysm of the Brachiocephalic Artery After Blunt Thoracic Contusion

Cited by 23 publications

References 26 publications

Innominate artery aneurysm, how to solve it?

Innominate artery aneurysm, how to solve it?

Concurrent Carotid Rupture and Coronary Dissection After Blunt Chest Trauma

Acute traumatic tear of the base of the brachiocephalic artery after blunt trauma: report of a rare case and review of the literature

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