Penetrating Injuries to the Innominate Artery in Association with Abnormal Aortic Arch Anatomy

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Penetrating trauma to the innominate artery is uncommon and even more unusual when associated with aberrant or unfamiliar anatomical variants as proximal clamping of a common innominate or carotid trunk may result in occlusion of almost all antegrade flow to the brain. We describe three patients that presented over a 4-year period with penetrating trauma of the proximal innominate associated with an abnormal origin of the left carotid artery and a variant of the aberrant right subclavian anomaly where both carotids originated from a common trunk.