Minimally Invasive Approach and Endovascular Techniques for Vascular Trauma
Vascular injury continues to be associated with high morbidity and mortality rates, requiring timely and effective management in the earliest phases after injury in order to optimize outcomes. The management of these injuries has traditionally required operative surgical intervention. In recent years, however, the evolution of endovascular technologies has expanded the therapeutic modalities available to trauma providers. Endovascular intervention for vascular injury may particularly hold promise in the treatment of vascular injuries at locations that demand complex or challenging exposures in order to facilitate effective repair.
Hybrid approaches, designed to facilitate expeditious proximal vascular control and provide time for improved exposure and open repair, have also been suggested as promising roles for these evolving technologies. The optimal role of endovascular treatment for vascular injury, however, requires additional investigation. The deficiency of outcomes data compared to open repair and the absence of consensus indications require further study in order to adequately define the role of endovascular technologies in vascular injury treatment algorithms.
KeywordsVascular Injury Endovascular Intervention Vascular Trauma Open Surgical Intervention Thoracic Endovascular Aortic Repair
(WMV 860 kb)
- 5.Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O’Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Lineen E, Marguiles D, Malka V, Chan LS (2009) Blunt traumatic thoracic aortic injuries: early or delayed repair—results of an American Association for the Surgery of Trauma prospective study. J Trauma 66(4):967–973PubMedCrossRefGoogle Scholar
- 6.Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O’Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Lineen E, Marguiles D, Malka V, Chan LS, American Association for the Surgery of Trauma Thoracic Aortic Injury Study Group (2008) Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma 64(3):561–570; discussion 570–571PubMedCrossRefGoogle Scholar
- 7.Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O’Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Lineen E, Marguiles D, Malka V, Chan LS (2008) Diagnosis and treatment of blunt thoracic aortic injuries: changing perspectives. J Trauma 64(6):1415–1418; discussion 1418–1419PubMedCrossRefGoogle Scholar
- 9.DiCocco JM, Fabian TC, Emmett KP, Magnotti LJ, Zarzaur BL, Bate BG, Muhlbauer MS, Khan N, Kelly JM, Williams JS, Croce MA (2011) Optimal outcomes for patients with blunt cerebrovascular injury (BCVI): tailoring treatment to the lesion. J Am Coll Surg 212(4):549–557; discussion 557–559PubMedCrossRefGoogle Scholar
- 11.DuBose JJ, Rajani R, Gilani R, Arthurs ZA, Morrison JJ, Clouse WD, Rasmussen TE, For the Endovascular Skills for Trauma and Resuscitative Surgery (ESTARS) Working Group (2012) Endovascular management of axillo-subclavian arterial injury: a review of published experience. Injury 43(11):1785–1792PubMedCrossRefGoogle Scholar
- 17.Trellopoulos G, Georgiadis GS, Asianidou EA, Nikolopoulos ES, Pitta X, Papachristodoulou A, Lazarides MK (2012) Endovascular management of peripheral artery trauma in patients presenting in hemorrhagic shock. J Cardiovasc Surg (Torino) 53(4):495–506Google Scholar