Traumatic Aortic Tear

CTA chest: Aortic tear at ligamentum arteriosum level with extensive RT hemothorax

Up to 15% of all deaths following motor vehicle collisions are due to injury to the thoracic aorta.  The proximal descending aorta, where the relatively mobile aortic arch can move against the fixed descending aorta at theligamentum arteriousm, is at greatest risk from the shearing forces of sudden deceleration.Chest X-ray is still used as the primary screening study, but has a low sensitivity. The sensitivity of modern CT scanners is reported at 97-100%, with a negative predictive value of 100% and specificity of 83-99%. Many surgeons  rely solely on the CT scan to plan operative or endovascular repair. Endovascular repair of thoracic aortic injury is available.

Reference: trauma.org 9:4, April 2004 Chest Trauma: Traumatic Aortic Injury