Abstract
BACKGROUND: The current clinical practice guidelines for blunt traumatic aortic injury (BTAI) as set by the Society for Vascular Surgery recommend non-operative management in grade I injuries and thoracic endovascular aortic repair (TEVAR) or surgical repair for grade II-IV injuries. Several studies have reported successful non-operative management of grade I and II BTAI. However, non-operative management of BTAI greater than grade II has not been well-demonstrated. The purpose of this study is to examine outcomes in operative and non-operative management of patients with Grade II, III, and IV BTAI. METHODS: In this retrospective study of 24 patients, the Hackensack Meridian Health Jersey Shore University Medical Center trauma registry and electronic medical record (2011-2021) were used to identify adults ([Formula: see text]18 years old) with grade II, III, and IV BTAI. Management was characterized as non-operative or operative. The primary outcome of this study was improvement of aortic injury which is defined as a lack of lesion progression or resolution of the lesion on a follow-up CT scan. RESULTS: Non-operative patients had lower improvement percentages (33.3%) compared to the operative group (83.3%). Non-operative patients also had increased hospital mortality (66.7%) compared to the operative group (0%). DISCUSSION: Patients with a higher grade BTAI showed greater improvement and had better outcomes with operative management, than non-operative management. However, large sample size studies are needed to verify these findings.