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Endovascular therapy in trauma

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

The practice of medicine has experienced a revolution in the use of catheter-based or endovascular techniques to manage age-related vascular disease over the past 15 years. In many scenarios the less invasive, endovascular method is associated with reduced morbidity and mortality than the traditional open surgical approach. Although somewhat delayed, the use of endovascular approaches in the management of certain trauma scenarios has also increased dramatically. With improvements in catheter-based and imaging technologies and a broader acceptance of the value of the endovascular approach, this trend is likely to continue to the benefit of patients. The use of endovascular techniques in trauma can be considered in three broad categories: (1) large-vessel repair (e.g. covered stent repair), (2) mid- to small-vessel hemostasis (e.g. coils, plugs, and hemostatic agents), and (3) large-vessel balloon occlusion for resuscitation (e.g. resuscitative endovascular balloon occlusion of the aorta). While not exclusive, these categories provide a framework from which to consider establishing a trauma-specific endovascular inventory and performance of these techniques in the setting of severe injury. The aim of this review is to use this framework to provide a current appraisal of endovascular techniques to manage various forms: vascular injury, bleeding, and shock; including injury patterns in which an endovascular approach is established and scenarios in which it is nascent and evolving.

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Conflict of interest

M. Brenner, M. Hoehn, and T. E. Rasmussen declare that they have no conflict of interest.

Compliance with ethical requirements

This work is in compliance with ethical requirements. M. Brenner, M. Hoehn, and T. E. Rasmussen declare that this is a review article that includes no studies on humans or animals.

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Authors and Affiliations

  1. University of Maryland Shock Trauma Center, Baltimore, MD, USA

    M. Brenner, M. Hoehn & T. E. Rasmussen

  2. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    T. E. Rasmussen

  3. US Combat Casualty Care Research Program, 722 Doughten Street, Room 3, Fort Detrick, MD, 21702-5012, USA

    T. E. Rasmussen

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  1. M. Brenner
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Correspondence to T. E. Rasmussen.

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The views expressed in this manuscript are those of the authors and do not reflect the official position or policy of the United States Air Force or the Department of Defense.

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Brenner, M., Hoehn, M. & Rasmussen, T.E. Endovascular therapy in trauma. Eur J Trauma Emerg Surg 40, 671–678 (2014). https://doi.org/10.1007/s00068-014-0474-8

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  • DOI: https://doi.org/10.1007/s00068-014-0474-8

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