[Injuries of the thoracic blood vessels--diagnosis and therapy].

: Thoracic vascular trauma is divided into perforating and nonperforating injuries. Patients with perforating lesions with median sternotomy has to be performed if circulation is still functioning marginally. In a severe hemorrhagic shock it can be necessary to do an immediate emergency lateral thoracotomy. Trauma of the thoracic aorta occurs most frequently as a consequence of blunt injury as a result of decelerate or crushing. Fewer than 20% of patients with thoracic aortic injury survive the initial insult. Additionally the survival depends on severity of associated injuries. This means that the timing of surgical intervention in the stable, covered aortic rupture with serious associated injuries should preferably be deferred until the patients condition is stabilized. Emergency operation has to be performed in case of symptomatic transaction in the hemodynamic unstable condition including simultaneous surgery of concomitant lesions. Paraplegia remains the most deleterious problem. Endovascular stents are used increasingly to treat traumatic rupture of the aorta.