Highlights
- •As CT image quality improves, smaller traumatic injuries are increasingly being identified.
- •Grade I blunt thoracic aortic injuries do not require immediate repair nor worsen to require later operative intervention.
- •Thus, close surveillance imaging is not necessary for grade I injuries.
Abstract
Background
No evidence-based recommendations exist for imaging surveillance of grade I blunt
thoracic aortic injuries (BTAI). We aimed to evaluate the natural history of these
injuries to provide guidance for follow-up imaging.
Methods
Patients that presented to our trauma center from 2008 to 2021 with grade I BTAI were
retrospectively evaluated. CT angiography images were assessed for initial injury
grade and subsequent stability, improvement, worsening, or resolution.
Results
Of 83 patients who had grade I injuries and repeat imaging, 57.8% had complete resolution,
20.5% had improvement, and 18.1% had stability of their injury. Only seven patients
(8.4%) demonstrated worsening of their injury. Six patients had eventual resolution
and one underwent endovascular repair that would not have been performed under current
practice patterns.
Conclusions
Since grade I injuries do not worsen to require later surgical intervention, early
surveillance imaging is not necessary and further imaging may not be necessary at
all.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
BTAI (blunt thoracic aortic injury), SVS (Society of Vascular Surgery), CTA (CT angiography)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 09, 2022
Accepted:
June 7,
2022
Received in revised form:
May 31,
2022
Received:
April 25,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
