CTICasesInternal Mammary Artery Injury
Imaging findings
Chest CT in a patient with chest trauma demonstrates a fracture and posterior displacement of a costal cartilage at its sternal articulation. The adjacent right internal mammary artery is well-opacified proximally but abruptly cuts off at the level of the cartilage injury, with surrounding soft-tissue hematoma and gas. Catheter angiography confirms internal mammary artery occlusion/spasm, which is successfully embolized.
Key takeaways
Traumatic injury to the internal mammary (internal thoracic) artery is a potentially life-threatening complication of blunt or penetrating anterior chest wall trauma, often associated with sternal or costal cartilage fractures. It can result in massive chest wall hematoma, hemothorax, or active bleeding, and is typically treated via transcatheter coil or glue embolization.
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