Endovascular treatment of penetrating arterial trauma with stent grafts

Abstract

The endovascular treatment of penetrating arterial injuries with covered stents is feasible. However, the criteria used to choose the best method must be individualized.

Explore no more: Early experience with a novel minimally invasive approach to penetrating trauma to zone II of the neck

“…Previous case reports with insertion of stents in penetrating arterial injury have not reported infectious complications. 2 , 9 Our patient did not show any signs of infection during follow-up. Long-term outcomes data for the use of carotid stents in the young population are not available.…”

Successful management with endovascular stent graft repair following gunshot wound to the subclavian artery: Case report and literature review

“…In a 13-year retrospective review, penetrating injuries more often resulted in proximal subclavian artery injuries when compared to middle and distal injuries [12]. Furthermore, penetrating injuries in this area are usually the result of gunshot wounds and, less likely, stab wounds [13,14]. In a 10-year retrospective review, Lin and colleagues reported that the exact mechanism of injury was associated with outcome differences with stab wounds resulting in an 80% survival rate and gunshot wounds resulting in a 63% survival rate [13].…”

“…Endovascular approaches for penetrating arterial trauma, which are not limited to only subclavian artery injuries, include embolization and stent graft repair. Stent graft repair is often the preferred approach as it preserves blood flow [14]. The use of many different types of stents in the treatment of axillo-subclavian artery injuries have been reported.…”

“…There are a number of factors which ultimately guide the type of stent to utilize including surgeon preference, availability, and the characteristics and location of the lesion. For injuries resulting from stab wounds and gunshot wounds, self-expanding covered stents are typically desired due to their flexibility and ability to conform to multiple diameters in a single artery [14]. This is especially useful for vessels which are difficult to fully visualize such as the subclavian artery.…”

“…Failure of endovascular repair is typically the result of an inability to pass the guidewire across the length of the lesion [3]. Notwithstanding, endovascular approaches offer several advantages over open approaches such as remote access, shorter operative time, less blood loss, lower incidence of sepsis, and a reduced risk of injury to surrounding structures [2,3,8,14,[17], [18], [19], [20], [21]]. Additionally, quicker recovery time and a decreased length of hospital stay are associated with endovascular approaches [22].…”