• T J Dosios, N Salemis, D Angouras, and E Nonas.
• 2nd Department of Propedeutic Surgery, Athens University Medical School, Greece. dosiosth@internet.gr
• J Trauma. 2000 Oct 1;49(4):696-703.

BackgroundDue to the highly lethal nature of trauma of the thoracic aorta and aortic arch branches (TA-AAB), autopsy studies are essential for the investigation of its epidemiologic characteristics.MethodsThe reports of 11,446 consecutive medicolegal autopsies were reviewed. 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.ResultsBlunt TA-AAB injuries were recorded in 86.4% of the victims. They were located mainly at the aortic isthmus and distal descending thoracic aorta and were accompanied to a great extent by extrathoracic trauma. The vast majority of penetrating lacerations were located at the ascending aorta, arch, and arch branches and were mostly associated with other lethal intrathoracic injuries. All penetrating trauma victims died before reaching the hospital, whereas 5.5% of the blunt trauma victims were admitted to the hospital alive.ConclusionMajor 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 chances of reaching the hospital alive.

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