Traumatic injury to the blood vessels of the thorax can be graded using the Thoracic Vascular Organ Injury Scale.
Blood Vessel |
Grade |
intercostal artery or vein |
I |
internal mammary artery or vein |
I |
bronchial artery or vein |
I |
esophageal artery or vein |
I |
hemiazygous vein |
I |
unnamed artery or vein |
I |
azygous vein |
II |
internal jugular vein |
II |
subclavian vein |
II |
innominate vein |
II |
carotid artery |
III |
innominate artery |
III |
subclavian artery |
III |
thoracic aorta, descending |
IV |
inferior vena cava (intrathoracic) |
IV |
pulmonary artery, primary intraparenchymal branch |
IV |
pulmonary vein, primary intraparenchymal branch |
IV |
thoracic aorta, ascending and arch |
V |
superior vena cava |
V |
pulmonary artery, main trunk |
V |
pulmonary vein, main trunk |
V |
uncontained total transection of the thoracic aorta or pulmonary hilum |
VI |
Additional rules for deriving final grade:
(1) If more than 1 Grade III and Grade IV injuries that involve > 50% of vessel circumference are present, then increase the final Grade by 1 (to Grade IV from Grade III; to Grade V from Grade IV).
(2) If a grade IV or Grade V injury is limited to < 25% of vessel circumference, then reduce the final Grade by 1 (to Grade III from Grade IV; to Grade IV from Grade V).
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Cardiology
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