Aortic Trauma by Jody Shen, MD, Stanford Radiology

Learn about key imaging findings and classification systems for acute aortic injuries in this 24-minute Stanford Radiology lecture. Explore the mechanisms and patterns of Blunt Traumatic Aortic Injury (BTAI), including typical injury locations and signs on chest radiographs. Understand the SVS and Harborview classifications, and examine various case studies to recognize different types of aortic injuries. Discover potential mimics and pitfalls in diagnosis, such as atherosclerosis and the ductus bump. Gain insights into post-TEVAR (Thoracic Endovascular Aortic Repair) findings and potential complications. Enhance your ability to interpret radiological images and make informed decisions in trauma cases involving aortic injuries.

Blunt Traumatic Aortic Injury for the Radiologist
Discuss mechanism and patterns of BTAI
Review BTAI classification and management
Recognize post-repair normal appearance and
Mechanism: Frontal impact in MVC
Typical locations of BTAI
Aortic isthmus is most injured site
Signs on chest radiograph
Terminology: Transection versus dissection
"Transection" meaning?
SVS Classification
Intimal Tear
Intramural hematoma
SVS → Harborview Classification
MAI: Subcentimeter intimo-medial abnormality with no external contour deformity
43 M trauma transfer after ATV accident
44 M presents after MCC
38 F trauma transfer after MVC
90 F rear-ended a truck at 35 mph
31 M presents after MVC at 70 mph
Mimics: Atherosclerosis/floating thrombus
14 M presents after MVC
59 F MVC rollover, question aortic injury at OSH
Pitfall: Ductus bump
Aortic isthmus types
Ductus bump versus pseudoaneurysm
57 F presents after MVC
66 M trauma
34 F presents for follow-up after MVC
50 F trauma transfer after a 50 ft fall
21 M trauma transfer after MVC
Expected post-TEVAR findings
LSA coverage with thrombus
Bovine arch with CVA after TEVAR
Remote TEVAR with endograft infection
Other complications: Endoleak
Other complications: Stent-graft collapse
Aorta is most commonly injured at the isthmus
Morphology of BTAI directs management
Stanford MEDICINE Radiology