BACKGROUND: Blunt trauma causing injury to the vessels of the aortic arch is uncommon but may be attended by serious consequences. Most surgeons will experience only an occasional case and will need to rely on published literature for guidance.
METHODS: A Medline search over 1986-1995 was carried out using the following keywords: brachiocephalic trunk, common carotid artery and subclavian artery; injury was used as a subheading.
RESULTS AND CONCLUSION: After the aortic isthmus, the innominate is the most commonly injured artery in the chest. Whatever the site of an arterial lesion, however, angiography is the diagnostic test of choice. Some vascular lesions are relatively benign and may be managed without operation; this form of management may also be appropriate if there is severe associated neurological injury. Otherwise, operation using an approach and technique suited to the site of the injury is advocated.