XXXX of the innominate artery.

@entity1 @entity712 @entity548 @entity254 @entity542 @entity397 @entity299 @entity1317 @entity6830 @entity9440 @entity130
OBJECTIVE: Blunt traumatic rupture of the innominate artery is uncommon. We reviewed our experience to correlate the impact of @entity1 stability, presence of associated @entity130 and location of the @entity1317 with outcome. METHODS: A retrospective review was performed of @entity1 admitted between January 1, 1998 and December 17, 2002 with traumatic innominate @entity397 . Injuries were defined as proximal if they were <or=0.5cm from the origin, distal if <or=0.5cm from the bifurcation and middle if in between. RESULTS: Over the 5-year study period, 66 @entity1 were admitted with aortic or great @entity130 , including eight with blunt innominate artery disruption. Of the blunt innominate @entity130 , six involved the origin (five repaired by ascending aortic-innominate artery graft followed by over-sewing of the injury site, one by ligation alone), one middle (treated by interposition graft) and one distal (managed with resection and primary @entity254 ). Four of the @entity1 with proximal @entity130 had evidence of active @entity548 (large expanding @entity548 ) requiring control of the injury site prior to reconstruction. All @entity1 had associated @entity130 (including closed @entity542 in three and @entity9440 in two). The only mortality occurred in a @entity1 who presented in shock, and suffered @entity397 and severe blunt @entity299 requiring cardiopulmonary bypass. The remaining @entity1 were stable on presentation. Diagnosis was suspected after chest X-ray demonstrated widened @entity6830 and was confirmed with either angiography or computer tomography scan. There were no complications in the survivors. Neither cardiopulmonary bypass nor aorto-carotid shunting was utilized in these cases. CONCLUSIONS: @entity1 with blunt innominate @entity397 who survive to admission are usually stable and the diagnosis is suggested by initial chest radiograph. The @entity130 are usually proximal, requiring aortic-distal innominate bypass. Cardiopulmonary bypass is required only if there is evidence of @entity712 (either before or after partial occlusion of the aorta) or to manage specific associated @entity130 .
