Thoracic vascular injuries require an appropriate diagnostic approach
to plan exposure and control. Penetrating injuries to the thoracic gre
at vessels typically present with unstable hemodynamics and require em
ergent operation. Arteriography is extremely useful to plan the operat
ive approach in stable patients with injuries to the brachiocephalic v
essels. Other topics discussed include incisions for exposure and cont
rol, operative techniques and adjuncts, and postoperative care.