Description

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).

 


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