Unsuspected vascular trauma: blunt arterial injuries

Blunt traumatic injuries to major arteries are an uncommon, but important source of morbidity and mortality in traumatized patients. Blunt arterial injury in the absence of associated orthopedic injury may be overlooked easily, however, with devastating consequences. Although some of these injuries may be obvious on initial assessment, in many instances, clinical indicators may be subtle or nonspecific, and definitive diagnoses are likely to require specialized radiographic or ultrasound imaging. Although any vessel, including the abdominal aorta, may be injured by blunt trauma, certain injury patterns should prompt consideration of associated arterial injuries. Recognition of these patterns affords the clinician the opportunity to obtain the specialized testing necessary to confirm the diagnosis. This article examines blunt traumatic injuries to the thoracic aorta and cervical, iliac, and femoral arteries.