Blunt and penetrating trauma of the thoracic aorta and aortic arch branches: An autopsy study

Background: Due to the highly lethal nature of trauma of the thoracic aorta and aortic arch branches (TA-AAB), autopsy studies are essential for the i nvestigation of its epidemiologic characteristics. Methods: The reports of 11,446 consecutive medicolegal autopsies were revie wed. Among 1,980 injury-related fatalities, 251 victims (12.7%) with 302 TA -AAB injuries were found. Several trauma variables were recorded and their relations were examined. Results: Blunt TA-AAB injuries were recorded in 86.4% of the victims. They were located mainly at the aortic isthmus and distal descending thoracic ao rta and were accompanied to a great extent by extrathoracic trauma. The vas t majority of penetrating lacerations were located at the ascending aorta, arch, and arch branches and were mostly associated with other lethal intrat horacic injuries. All penetrating trauma victims died before reaching the h ospital, whereas 5.5% of the blunt trauma victims were admitted to the hosp ital alive. Conclusion: Major differences between blunt and penetrating TA-AAB injuries were revealed, regarding their location, patterns of concomitant injuries, and victims' survival time. Patients injured in motor vehicle crashes, as opposed to various other causes of trauma, were found to have the best chan ces of reaching the hospital alive.