Thoracic vascular injury-trauma grading

Thoracic vasculature injuries are graded I-VI with increasing severity having higher grading (e.g. grade VI injuries are not salvageable).

Grade I

• Intercostal artery/vein
• Internal mammary artery/vein
• Bronchial artery/vein
• Esophageal artery/vein
• Hemiazygous vein
• Unnamed artery/vein

Grade II

• Azygous vein
• Internal jugular vein
• Subclavian vein
• Innominate (brachiocephalic) vein

Grade III

• Carotid artery
• Innominate (brachiocephalic) artery
• Subclavian artery

Grade IV

• Thoracic aorta (descending)
• Inferior vena cava (intrathoracic)
• Pulmonary artery (primary intraparenchymal branch)
• Pulmonary vein (primary intraparenchymal branch)

Grade V

• Thoracic aorta (ascending & arch)
• Superior vena cava
• Pulmonary artery (main trunk)
• Pulmonary vein (main trunk)

Grade VI

• Total transection of thoracic aorta (uncontained)
• Total transection of pulmonary hilum (uncontained)

Note that one grade increase is indicated for multiple grade III or IV injuries involving more than 50% of the circumference of the vessel. A decrease of one grade is indicated for grades IV & V injuries if <25% of the circumference of the vessel is involved.

References

Moore EE, et al. Organ injury scaling IV: thoracic vascular, lung, cardiac and diaphragm. J Trauma. 1994;36:229. Trauma scoring. Trauma.org. Available at http://www.trauma.org/archive/scores/ois-thrcvasc.html (Accessed 23 April 2008)

[Outline]

• Information
• Grade I
• Grade II
• Grade III
• Grade IV
• Grade V
• Grade VI
• References