The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 633-638, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Role of angiography in cervicothoracic trauma
AN Thomas, PC Goodman and AJ Roon
The role of angiography in cervicothoracic trauma is controversial. Since
1967 the policy at San Francisco General Hospital has been to use liberal
indications for angiography in hemodynamically stable patients with either
penetrating or blunt cervicothoracic trauma. The 304 patients in Group 1
had emergency angiographic evaluation: 102 had penetrating cervical wounds:
202 had thoracic injuries-71 penetrating and 131 blunt trauma. During the
same time period, 72 patients (Group II) had cervical or thoracic vascular
injuries and underwent operative treatment without preoperative
angiography. Sixty-six patients in Group 1 had significant vascular injury.
Thirty patients with penetrating cervical injury had 38 vascular lesions.
Thirty-six patients with gunshot or blunt chest trauma had 43 vascular
lesions. Group II patients had two main indications for operation:
exanguinating hemorrhage (45 patients) or suspected vascular injury,
usually associated with hemorrhage (27 patients). Angiographic results were
useful whether abnormal or normal. In cases with adnormal findings
operative treatment was specific and improper incisions were avoided. In
cases with normal angiographic results, clarification of the vascular
status avoided unnecessary operations and permitted concentration of
therapeutic effort upon the main clinical problems of the patients.
