Skip to main content
SpringerLink
Log in

Vascular Injuries

  • Chapter
  • First Online:
Textbook of Polytrauma Management

  • 1546 Accesses

Abstract

The highest goal in Damage control surgery is to stop the bleeding. Major injuries to the vessels therefore pose the major challenge in the damage control approach. Optimal care can be provided in combination receiving and treatment rooms with CT, operative and endovascular capabilities. For patients in extremis REBOA is a new technique to stabilize patients preventing the need for emergency room thoracotomy. General damage control management techniques for vascular injuries comprise temporary closure by tourniquets, compression devices and intra as well as extra vascular balloons. Intra operatively manual compression and stick swabs can be used for temporary control of the bleeding. For more definitive closure, ligation as well as endovascular coiling can be used. For flow restoration temporary indwelling stents can be used, whereas for more permanent use both anatomic, as well as extra anatomic stent grafting are used as a permanent solution.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tiel Groenestege-Kreb D, van Maarseveen O, Leenen L. Trauma team. Br J Anaesth. 2014;113(2):258–65.

    Article  CAS  PubMed  Google Scholar 

  2. Hughes CW. Use of an intra-aortic balloon catheter tamponade for controlling intra abdominal hemorrhage in man. Surgery. 1954;36:65–8.

    CAS  PubMed  Google Scholar 

  3. White JM, Cannon JW, Stannard A, Markov NP, Spencer JR, Rasmussen TE. Endovascular balloon occlusion of the aorta is superior to resuscitative thoracotomy with aortic clamping in a porcine model of hemorrhagic shock. Surgery. 2011;150:400–9.

    Article  PubMed  Google Scholar 

  4. Avaro JP, Mardelle V, Roch A, et al. Forty-minute endovascular aortic occlusion increases survival in an experimental model of uncontrolled hemorrhagic shock caused by abdominal trauma. J Trauma. 2011;71:720–5.

    CAS  PubMed  Google Scholar 

  5. Martinelli T, Thony F, Declety P, et al. Intra-aortic balloon occlusion to salvage patients with life-threatening hemorrhagic shock from pelvic fractures. J Trauma. 2010;68:942–8.

    PubMed  Google Scholar 

  6. Morrison JJ, Ross JD, Houston R 4th, Watson JD, Sokol KK, Rasmussen TE. Use of resuscitative endovascular balloon occlusion of the aorta in a highly lethal model of noncompressible torso hemorrhage. Shock. 2014;41(2):130–7.

    Article  PubMed  Google Scholar 

  7. Brenner ML, Moore LJ, DuBose JJ, Tyson GH, McNutt MK, Albarado RP, Holcomb JB, Scalea TM, Rasmussen TE. A clinical series of resuscitative endovascular balloon occlusion of the aorta for hemorrhage control and resuscitation. J Trauma Acute Care Surg. 2013;75(3):506–11.

    Article  PubMed  Google Scholar 

  8. Scott DJ, Eliason JL, Villamaria C, Morrison JJ, Houston R 4th, Spencer JR, Rasmussen TE. A novel fluoroscopy-free, resuscitative endovascular aortic balloon occlusion system in a model of hemorrhagic shock. J Trauma Acute Care Surg. 2013;75(1):122–8.

    Article  PubMed  Google Scholar 

  9. Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. J Trauma Acute Care Surg. 2011;71:1869.

    Article  Google Scholar 

  10. Tsurukiri J, Akamine I, Sato T, Sakurai M, Okumura E, Moriya M, Yamanaka H, Ohta S. Endovascular balloon occlusion of the aorta for uncontrolled haemorrahgic shock as an adjunct to haemostatic procedures in the acute care setting. Scand J Trauma Resusc Emerg Med. 2016;24:13.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kirkpatrick AW, Vis C, Dube M, Biesbroek S, Ball CG, Laberge J, Shultz J, Rea K, Sadlerf D, Holcomb JB, Kortbeek J. The evolution of a purpose designed hybrid trauma operating room from the trauma service perspective: The RAPTOR (resuscitation with angiography percutaneous treatments and operative resuscitations). Injury. 2014;45:1413–21.

    Article  PubMed  Google Scholar 

  12. Pryor JP, Braslow B, Reilly PM, Gullamondegi O, Hedrick JH, Schwab CW. Increasing role of angiography in trauma. J Trauma. 2005;59:102–4.

    Article  PubMed  Google Scholar 

  13. Zealley IA, Chakraverty S. The role of interventional radiology in trauma. BMJ. 2010;340:c497.

    Article  PubMed  Google Scholar 

  14. Gross T, Messmer P, Amsler F, Fuglistaler-Montali I, Zurcher M, Hugli RW, Regazzoni P, Jacob AL. Impact of a multifunctional image-guided therapy suite on emergency multiple trauma care. Br J Surg. 2010;97:118–27.

    Article  CAS  PubMed  Google Scholar 

  15. Kragh JF, Baer DG, Walters TJ. Extended (16 hour) tourniquet application after combat wounds: a case report and review of current literature. J Orthop Trauma. 2007;21:274–8.

    Article  PubMed  Google Scholar 

  16. King RB, Filips D, Blitz S, Logsetty S. Evaluation of possible tourniquet systems for use in the Canadian forces. J Trauma. 2006;60:1061–71.

    Article  PubMed  Google Scholar 

  17. Welling DR, Burris DG, Hutton JE, Minken SL, Rich NM. A balanced approach to tourniquet use: lessons learned and relearned. J Am Coll Surg. 2006;203(1):106–15.

    Article  PubMed  Google Scholar 

  18. Dawson DL, Putnam AT, Light JT, Ihnat DM, Kissinger DP, Rasmussen TE, Bradley DV. Temporary arterial shunts to maintain limb perfusion after arterial injury: an animal study. J Trauma. 1999;47:64–76.

    Article  CAS  PubMed  Google Scholar 

  19. Clouse WD, Rasmussen TE, Peck MA, Eliason JL, Cox MW, Bowser AN, Jenkins DH, Smith DL, Rich NM. In-theater management of vascular injury: 2 years of balad vascular registry. J Amer Coll Surg. 2007;204:625–32.

    Article  Google Scholar 

  20. Rasmussen TE, Clouse WD, Jenkins DH, Peck MA, Eliason JL, Smith DL. The use of temporary vascular shunts as a damage control adjunct in the management of wartime vascular injury. J Trauma. 2006;61:8–15.

    Article  PubMed  Google Scholar 

  21. Reber PU, Patel AG, Sapio NLD, Ris HB, Beck M, Kniemeyer HW. Selective use of temporary intravascular shunts in coincident vascular and orthopedic upper and lower limb trauma. J Trauma. 2004;47:72–6.

    Article  Google Scholar 

  22. Alam HB, Chen Z, Jaskill A, Querol RILC, Koustov E, Inocencio R, Conran R, Seufert A, Ariaban N, Toruno K, Rhee P. Application of a zeolite hemostatic agent achieves 100% survival in a lethal model of complex groin injury in swine. J Trauma. 2004;56:974–83.

    Article  CAS  PubMed  Google Scholar 

  23. Ahuja N, Ostomel TA, Rhee P, Stucky GD, Conran R, Chen Z, Al-Mubarak GA, Velmahos G, Demoya M, Alam HB. Testing modified zeolite hemostatic dressings in a large animal model of lethal groin injury. J Trauma. 2006;61:1312–20.

    Article  PubMed  Google Scholar 

  24. Kheirabadi BS, Acheson EM, Deguzman R, Crissey JM, Delgado AV, Estep SJ, Holcomb JB. The potential ability of fibrin sealant dressing in repair of vascular injury in swine. J Trauma. 2007;62:94–103.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Trauma, UMC Utrecht, Utrecht, The Netherlands

    L. P. H. Leenen

Authors
  1. L. P. H. Leenen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. P. H. Leenen .

Editor information

Editors and Affiliations

  1. Department of Trauma Surgery, University Hospital Zürich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Department of Orthopaedic Surgery & Sports Medicine, The University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Joseph Borrelli Jr.

  3. Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA

    Ernest E. Moore

  4. Klinik für Traumatologie, University Hospital of Zürich, Zürich, Switzerland

    Roman Pfeifer

  5. Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Philip F. Stahel

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Leenen, L.P.H. (2022). Vascular Injuries. In: Pape, HC., Borrelli Jr., J., Moore, E.E., Pfeifer, R., Stahel, P.F. (eds) Textbook of Polytrauma Management . Springer, Cham. https://doi.org/10.1007/978-3-030-95906-7_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-95906-7_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95905-0

  • Online ISBN: 978-3-030-95906-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation