Penetrating Neck Injury to the Superior Thoracic Artery Managed by Video-Assisted Thoracoscopic Surgery

Figure 1

Radiographic images and schematic of vascular injury.

(a) Axial chest CT with intravenous contrast demonstrating active intrathoracic bleeding from a branch of the left superior thoracic artery. Red arrow points to the area of contrast extravasation

(b) 3D reconstruction of the images from (a). Yellow arrow points to the area of active contrast extravasation. White arrowhead points to thoracostomy tube

(c) Arteriogram of left axillary artery demonstrating contrast extravasation from the superior thoracic artery (yellow arrow). The small size of the bleeding vessel (∼1 mm) precluded any endovascular attempts to control bleeding

(d) Schematic of the major branches of the subclavian and axillary artery. Clavicle has been partially resected. Asterisk indicates superior thoracic artery