title: Evolution of lesion-specific management of blunt thoracic aortic injury.
abstract: Developments in diagnosis and treatment have transformed the management of blunt thoracic aortic injuries (BTAIs). For patients in stable condition, treatment practice has shifted from early open repair to nonoperative management for low-grade lesions and routine delayed endovascular repair for more significant injuries. However, effective therapy depends on accurate staging of injury grade and stability to select patients for appropriate management. Recent developments in BTAI risk stratification enable lesion-specific management tailored to the patient and aortic lesion. This review summarizes advances in lesion assessment and treatment and proposes an integrated scheme for the modern management of BTAI.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md. Electronic address: dharris@smail.umaryland.edu.
authors.forename: Donald G
authors.initials: DG
authors.lastname: Harris
authors.affiliation: R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rabin
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Wash.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Starnes
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif.
authors.forename: Ali
authors.initials: A
authors.lastname: Khoynezhad
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: R Gregory
authors.initials: RG
authors.lastname: Conway
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Center for Aortic Disease, University of Maryland Medical Center, Baltimore, Md.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Taylor
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Center for Aortic Disease, University of Maryland Medical Center, Baltimore, Md.
authors.forename: Shahab
authors.initials: S
authors.lastname: Toursavadkohi
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Center for Aortic Disease, University of Maryland Medical Center, Baltimore, Md.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Crawford
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D003661:Decision Support Techniques; D003663:Decision Trees; D006801:Humans; D015601:Injury Severity Score; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*