The surgical management of acute and chronic injuries of the thoracic aorta.

The clinical diagnosis of traumatic descending thoracic aortic aneurysm is not obvious but is usually suggested on a roentgenogram of the chest. The diagnosis, therefore, is based upon a high index of suspicion and confirmed by an angiogram. Femoral-femoral bypass is a safe approach, assuring adequate distal perfusion and, thereby, avoiding problems of ischemia. By assuring adequate distal perfusion and preserving all possible intercostal arteries, spinal cord injury was avoided in this series.