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Thoracic Aortic Injury

trauma-list@trauma.org trauma-list@trauma.org
Sat, 08 Feb 2003 22:00:07 -0500 

Karim

1. on the original aortogram there is luminal narrowing of the brachiocephalic artery. Could be secondary to a real injury rather than just vasospasm
i would repeat the aortogram before treatment

2. The stent graft extends too proximally with the struts at the level of the great vessel origins. however we have seen endothelialization of those wires crossing orifices with good results. There appeared to be more than satisfactory length distal to the left subclavian orifice.

3. the stent graft appears too long and unnecessarily crosses too many intercostal arteries. 

in this case i would worry about cerebrovascular insult from emboli off the wires. as well as spinal cord ischemia.

sal Sclafani


In a message dated 2/8/2003 2:42:13 PM Eastern Standard Time, karim@trauma.org writes:

> 
> 
> Here are 3 images taken during a thoracic stent graft procedure for a blunt
> aortic injury sustained in a motor vehicle collision.  
> There is a problem -
> can you spot it?
> 
> Karim

sal