Close surveillance imaging is unnecessary for patients with grade I blunt thoracic aortic injury

Sayuri P Jinadasa¹, Ariel L Mueller², Annie Apffel³, Brandon Cave⁴, Joseph J DuBose⁵, Thomas M Scalea⁶, Rishi Kundi⁷

Affiliations

¹ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: sayuri.jinadasa@som.umaryland.edu.
² Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: almueller@mgh.harvard.edu.
³ University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD, 21201, USA. Electronic address: aapffel@som.umaryland.edu.
⁴ University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD, 21201, USA. Electronic address: bcave@som.umaryland.edu.
⁵ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: joseph.dubose@austin.utexas.edu.
⁶ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: tscalea@som.umaryland.edu.
⁷ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: rkundi@som.umaryland.edu.

PMID: 35728986
DOI: 10.1016/j.amjsurg.2022.06.007

Close surveillance imaging is unnecessary for patients with grade I blunt thoracic aortic injury

Sayuri P Jinadasa et al. Am J Surg. 2022 Nov.

. 2022 Nov;224(5):1324-1328.

doi: 10.1016/j.amjsurg.2022.06.007. Epub 2022 Jun 9.

Authors

Sayuri P Jinadasa¹, Ariel L Mueller², Annie Apffel³, Brandon Cave⁴, Joseph J DuBose⁵, Thomas M Scalea⁶, Rishi Kundi⁷

Affiliations

¹ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: sayuri.jinadasa@som.umaryland.edu.
² Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: almueller@mgh.harvard.edu.
³ University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD, 21201, USA. Electronic address: aapffel@som.umaryland.edu.
⁴ University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD, 21201, USA. Electronic address: bcave@som.umaryland.edu.
⁵ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: joseph.dubose@austin.utexas.edu.
⁶ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: tscalea@som.umaryland.edu.
⁷ R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland School of Medicine, 22 S Greene Street, Baltimore, MD, 21201, USA. Electronic address: rkundi@som.umaryland.edu.

PMID: 35728986
DOI: 10.1016/j.amjsurg.2022.06.007

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.

Keywords: Blunt thoracic aortic injury; CT angiography; Surveillance imaging.

PubMed Disclaimer

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Close surveillance imaging is unnecessary for patients with grade I blunt thoracic aortic injury

Affiliations

Close surveillance imaging is unnecessary for patients with grade I blunt thoracic aortic injury

Authors

Affiliations

Abstract

MeSH terms

LinkOut - more resources

Full Text Sources

Medical