injury then the patient can be managed non surgically. Rather the patient can be followed with serial images. If the patient does develop a more severe injury including a full thickness injury through the media layer then the patient should be treated with surgery. Outcomes Thoracic aortic injury is the 2nd leading cause of death involving both blunt trauma. 80% of patients that have a thoracic aortic injury will die immediately. Of the patients that do make it to be evaluated only 50% will survive 24 hours. Of the patients that do survive the first 24 hours 14% develop paraplegia. Epidemiology Thoracic aortic injury is most commonly caused by a penetrating trauma in up to 90% of cases. Of these cases around 28% are confined to the thoracic portion of the aorta including the ascending aorta, aorta arch, and the descending aorta. Of the thoracic aortic injuries the ligament arteriosum is the most common location followed by the portion of the aorta after the origin of the left subclavian artery. The most common mechanism leading to thoracic aortic injury is a motor vehicle collision. Other mechanisms include airplane crashes, falling from a large height and landing on a hard surface, or any injury that causes substantial pressure to the sternum. The incidence of thoracic aortic injuries is approximately 1 in 100,000. References External links Chest trauma Injuries