Kenel-Pierre S, et al. - Blunt thoracic aortic injury (BTAI) patients subjected to thoracic endovascular aortic repair (TEVAR) under full, low-dose, and no intraoperative systemic heparinization were examined regarding their outcomes. Researchers identified 77 cases of confirmed BTAI at a high-volume urban trauma center during a period of 15 years and stratified them into three groups on the basis of the intraoperative use of heparin during TEVAR: full heparin (FH), low-dose heparin (LH), and no heparin (NH). As per outcomes, the heparinized and nonheparinized groups were not statistically significantly different in outcomes. The NH group showed the primary benefit in time to repair. The FH group had three times longer mean time to repair although this was not statistically significant. Further, prompt intervention and treatment were beneficial for patients in the NH group. Hence, intraoperative heparinization in critically ill patients with BTAI undergoing TEVAR continued to be at surgeon's discretion, although they suggest the lack of heparinization as a safe and potentially faster alternative, particularly in the polytrauma patient.