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Endovascular solutions for the management of penetrating trauma: an update on REBOA and axillo-subclavian injuries

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

Abstract

Purpose

Endovascular procedures continue to gain acceptance as management options for penetrating traumatic injuries. Currently, several areas of potential endovascular application are being investigated. However, the bulk of the literature on this topic is still limited to case series or small retrospective studies. Therefore, we performed a review of the published experience involving the application of endovascular therapy to trauma patients who have sustained penetrating injuries with focus on outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) and endovascular repair of axillo-subclavian injuries.

Methods

Published case reports, retrospective and prospective studies of REBOA and axillo-subclavian injuries were systematically reviewed.

Results

A total of 7 studies on REBOA and 10 studies on endovascular repair of axillo-subclavian injuries were included. Overall, REBOA was used as an adjunct for hemorrhage control and resuscitation in patients at risk of cardiopulmonary arrest, preventing further cardiovascular collapse successfully. For axillo-subclavian injuries, endovascular stent placement had efficacy comparable to the traditional open repair.

Conclusion

REBOA is a safe and effective alternative to open thoracotomy in critically ill trauma patients at risk of death due to torso hemorrhage. Endovascular repair outcomes are comparable to open repair after axillo-subclavian injuries. Long-term results of endovascular repair remain to be defined in this patient population.

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Author information

Authors and Affiliations

  1. Michael E. DeBakey Department of Surgery, Division of Vascular Surgery & Endovascular Therapy, Baylor College of Medicine, Houston, TX, USA

    B. C. Branco

  2. Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Division of Vascular Surgery, David Grant Medical Center, University of California-Davis, 101 Boden Circle, Travis Air Force Base, Davis, CA, USA

    J. J. DuBose

Authors
  1. B. C. Branco
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Corresponding author

Correspondence to J. J. DuBose.

Ethics declarations

Bernardino C. Branco and Joseph J. DuBose comply with the ethical guidelines for authorship and publishing in the European Journal of Trauma and Emergency Surgery. This article does not contain any studies with human or animal subjects performed by the authors.

Conflict of interest

Bernardino C. Branco and Joseph J. DuBose declare that they have no conflict of interest in relation to this work.

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Branco, B.C., DuBose, J.J. Endovascular solutions for the management of penetrating trauma: an update on REBOA and axillo-subclavian injuries. Eur J Trauma Emerg Surg 42, 687–694 (2016). https://doi.org/10.1007/s00068-016-0739-5

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  • DOI: https://doi.org/10.1007/s00068-016-0739-5

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