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Wed Aug 22 05:17:51 BST 2007

In a message dated 8/21/2007 6:09:53 PM W. Europe Daylight Time, 
aneurysm_42 at yahoo.com writes:

Those pictures are INCREDIBLY informative, now I'm
very glad that he received an aortogram; it made good
sense to do the four vessel given his altered mental
status without definite cause.  It probably saved the
patient an intraoperative stroke.  

After reviewing the films, this is a case I would
probably do under deep hypothermia and burst
supression.  Sew like the wind!  

I still maintain that this injury is conventionally
unstentable, but given the trajectory of this
discussion I'm sure that Sal is going to show us that
he was able to do the impossible.

Ben Reynolds, PA-C
Pittsburgh, PA

ben
one of the lessons i learned from this case was that a cerebral angiogram is 
indicated when innominate injuries are identified on aortography..

The last patient I  angio'ed for an innominate injury had an occipital 
cortical infarct resulting in field cut that went unrecognized during a two week 
stay in the  ICU. 

I wonder how our surgical colleagues would approach this injury now

sal

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Innom GSW: AH...THE FOUR VESSEL ANGIO