Use of open and endovascular surgical techniques to manage vascular injuries in the trauma setting: A review of the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial registry

Faulconer, E Robert; Branco, Bernardino C.; Loja, Melissa N.; Grayson, Kevin; Sampson, James B.; Fabian, Timothy C.; Holcomb, John B.; Scalea, Thomas M.; Skarupa, David; Inaba, Kenji; Poulin, Nathaniel; Rasmussen, Todd E.; DuBose, Joseph J.

doi:10.1097/ta.0000000000001776

Cited by 48 publications

(33 citation statements)

References 18 publications

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“…Forward endovascular management at MTFs mimics the practice observed in civilian medicine, in which endovascular approaches are increasingly common and have been shown to provide improved survival and lower complication rates in certain situations. 22,23,[29][30][31] Johnson et al 31 reported finding an additional vascular injury in more than half (53%) of patients who had sustained a combat-related vascular injury by liberally using angiography after evacuation to the United States; 50% required surgical repair. In another review of injury patterns between 2001 and 2004 by Fox et al, 19 the most common indication for arteriography was mechanism of injury (42%), followed by abnormal examination finding (33%), operative planning (18%), or evaluation of a repair (7%).…”

Section: Discussionmentioning

confidence: 99%

A contemporary, 7-year analysis of vascular injury from the war in Afghanistan

Patel

White

et al. 2018

Journal of Vascular Surgery

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The rate of vascular injury in modern combat is higher than that reported in previous wars. Open reconstruction is performed in half of cases, although ligation is an important damage control option, especially for minor or distal vessel injuries. Angiographic techniques are increasingly being used and documented within wartime registries more than ever. Proficiency with open and endovascular methods of vascular injury management remains a critical need for the U.S. military and will require partnership with civilian institutions to attain and maintain.

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Section: Discussionmentioning

confidence: 99%

A contemporary, 7-year analysis of vascular injury from the war in Afghanistan

Patel

White

et al. 2018

Journal of Vascular Surgery

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“…REBOA is an important resuscitative tool that ultimately prevents hemodynamic collapse while at the same time maintains coronary and cerebral perfusion in hemodynamically unstable trauma patients, and due to its less invasive nature, it has become an alternative to resuscitative thoracotomy [9][10][11][12][13][14][15][16] . Hörer et al proposed the concept of Endovascular Resuscitation and Trauma Management, a vision that integrates a multidisciplinary patient-centered approach that achieves prompt and effective hemorrhage control with significantly less surgical insult 6,17 .…”

Section: Discussionmentioning

confidence: 99%

REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients

et al. 2020

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Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient.

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“…They can be used as part of a temporary procedure with the objective of avoiding blood loss exsanguination, followed by a definitive treatment, as described here, or treatment may even be definitive in selected cases. 16…”

Section: Discussionmentioning

confidence: 99%

Tratamento endovascular de fístula tronco arterial braquiocefálico-traqueal: relato de caso e revisão de literatura

Machado¹,

Barroso²

2018

J. vasc. bras.

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Tracheo-innominate artery fistula (TIF) is a rare complication of tracheostomy, with incidence ranging from 0.1 to 1%, but mortality is high in untreated cases. Early signs range from self-limited bleeding to massive hemorrhage with hypovolemic shock. The caliber of the tracheostomy cannula, its position in contact with the tracheal wall, and tracheal cuff pressure can traumatize the mucosa and trigger development of a TIF. We describe the case of a 14-year-old female patient who had been tracheostomized at the age of eight because of head trauma. She later developed subglottic stenosis requiring dilation sessions for six years. During the fifth year of these sessions, she presented repetitive hemoptysis, initially treated by surgery to implant an expanded polytetrafluoroethylene graft. One year later, she had an intense hemorrhage, which was controlled using endovascular techniques followed by definitive surgery, performed electively. The patient was followed up for six months, without complications.

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Use of open and endovascular surgical techniques to manage vascular injuries in the trauma setting: A review of the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial registry

Abstract: III, Therapeutic/care management.

Cited by 48 publications

References 18 publications

A contemporary, 7-year analysis of vascular injury from the war in Afghanistan

A contemporary, 7-year analysis of vascular injury from the war in Afghanistan

REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients

Tratamento endovascular de fístula tronco arterial braquiocefálico-traqueal: relato de caso e revisão de literatura

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