Endovascular treatment of peripheral and visceral arterial injuries in patients with acute trauma

Ulus Travma Acil Cerrahi Derg. 2016 Nov;22(6):531-535. doi: 10.5505/tjtes.2016.92645.

Abstract

Background: The present study is an evaluation of the efficacy of endovascular treatment in emergency setting for patients with acute peripheral and visceral arterial injury secondary to penetrating or blunt trauma.

Methods: Twelve patients (11 men) aged 35.8±11.3 years (range: 18-56 years) with penetrating or blunt trauma who underwent endovascular treatment in our department between March 2010 and June 2014 for peripheral and visceral arterial injury were retrospectively reviewed. Selective coil embolization was performed on 11 patients and particle embolization of the injured vessel was performed on 1 patient. Criteria for endovascular treatment included active extravasation or pseudoaneurysm on contrast-enhanced computed tomography and decrease in hemoglobin level or temporary hemodynamic instability.

Results: Arterial injuries were secondary to penetrating injury due to gunshot wound in 4 patients and stab wound in 5, and blunt abdominal injury as result of traffic accident in 3 patients. Traumatic lesions were in the right hepatic artery (n=3), left hepatic (n=2), right hepatic and right renal (n=1), left inferior epigastric (n=2), left facial (n=1), anterior tibial (n=1), and deep femoral (n=1) arteries. Technical success with no procedural complications was seen in all cases. Two patients died due to coexisting injuries on 29th and 43rd days of hospitalization. Median hospitalization period was 6.0 days (range: 1-43 days) and mean intensive care unit hospitalization was 7.7 days (range: 0-43 days).

Conclusion: In our experience, endovascular treatment was a safe and effective option for acute traumatic peripheral and visceral arterial lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aneurysm, False / surgery
  • Arteries / injuries
  • Arteries / surgery
  • Blood Vessel Prosthesis Implantation
  • Embolization, Therapeutic
  • Emergency Treatment
  • Endovascular Procedures*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Turkey
  • Vascular System Injuries / diagnostic imaging
  • Vascular System Injuries / surgery*
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / surgery*
  • Wounds, Penetrating / diagnostic imaging
  • Wounds, Penetrating / surgery*
  • Young Adult