Endovascular management of traumatic peripheral arterial injuries
Abstract Background Traumatic injuries to peripheral arterial vessels are increasingly managed with endovascular techniques. Early small series have suggested that endovascular therapy is feasible and decreases operative blood loss, but these data are limited. The purpose of this study was to evalua...
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| Veröffentlicht in: | The Journal of surgical research 2015-12, Vol.199 (2), p.557-563 |
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| container_title | The Journal of surgical research |
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| creator | Scott, Aaron R., MD Gilani, Ramyar, MD Tapia, Nicole M., MD Mattox, Kenneth L., MD Wall, Matthew J., MD Suliburk, James W., MD |
| description | Abstract Background Traumatic injuries to peripheral arterial vessels are increasingly managed with endovascular techniques. Early small series have suggested that endovascular therapy is feasible and decreases operative blood loss, but these data are limited. The purpose of this study was to evaluate the feasibility and outcomes of endovascular management of nonaortic arterial trauma. Materials and methods We reviewed records of traumatic nonaortic arterial injuries presenting at an urban level 1 trauma center from December 2009–July 2013. Patients undergoing treatment in interventional radiology and patients whose injuries occurred >72 h before presentation were excluded. Demographics, indicators of injury severity, operative blood loss, transfusion requirements, and clinical outcome were compared between patients undergoing endovascular and open management using appropriate inferential statistics. Results During the study period, 17 patients underwent endovascular interventions and 20 had open surgery. There were 19 upper extremity and/or thoracic outlet arterial injuries, 15 lower extremity injuries and 11 pelvic injuries. Endovascular cases were completed using a vascular imaging C-arm in a standard operating room. Estimated blood loss during the primary procedure was significantly lower with endovascular management (150 versus 825 cc, P |
| doi_str_mv | 10.1016/j.jss.2015.04.086 |
| format | Article |
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Early small series have suggested that endovascular therapy is feasible and decreases operative blood loss, but these data are limited. The purpose of this study was to evaluate the feasibility and outcomes of endovascular management of nonaortic arterial trauma. Materials and methods We reviewed records of traumatic nonaortic arterial injuries presenting at an urban level 1 trauma center from December 2009–July 2013. Patients undergoing treatment in interventional radiology and patients whose injuries occurred >72 h before presentation were excluded. Demographics, indicators of injury severity, operative blood loss, transfusion requirements, and clinical outcome were compared between patients undergoing endovascular and open management using appropriate inferential statistics. Results During the study period, 17 patients underwent endovascular interventions and 20 had open surgery. There were 19 upper extremity and/or thoracic outlet arterial injuries, 15 lower extremity injuries and 11 pelvic injuries. Endovascular cases were completed using a vascular imaging C-arm in a standard operating room. Estimated blood loss during the primary procedure was significantly lower with endovascular management (150 versus 825 cc, P < 0.001). No differences were observed between cohorts in age, injury severity score, intensive care unit length of stay, arterial pH, transfusion requirements, inpatient complication rate, or mortality. Conclusions Our experience with endovascular management demonstrates its feasibility with commonly available tools. Operative blood loss may be significantly decreased using endovascular techniques. Further study is needed to refine patient selection criteria and to define long-term outcomes.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2015.04.086</identifier><identifier>PMID: 26115809</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Arterial trauma ; Arteries - injuries ; Arteries - surgery ; Blood Loss, Surgical - statistics & numerical data ; Endovascular Procedures - statistics & numerical data ; Endovascular therapy ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Operative blood loss ; Postoperative Complications - epidemiology ; Retrospective Studies ; Surgery ; Texas - epidemiology ; Treatment Outcome ; Vascular System Injuries - surgery ; Young Adult</subject><ispartof>The Journal of surgical research, 2015-12, Vol.199 (2), p.557-563</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c548t-1cd2f24dae9f4fc4c30ddf6acd7b87ddf681c2fdd13a3c453140b6e916b139373</citedby><cites>FETCH-LOGICAL-c548t-1cd2f24dae9f4fc4c30ddf6acd7b87ddf681c2fdd13a3c453140b6e916b139373</cites><orcidid>0000-0002-1210-3731</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2015.04.086$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26115809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scott, Aaron R., MD</creatorcontrib><creatorcontrib>Gilani, Ramyar, MD</creatorcontrib><creatorcontrib>Tapia, Nicole M., MD</creatorcontrib><creatorcontrib>Mattox, Kenneth L., MD</creatorcontrib><creatorcontrib>Wall, Matthew J., MD</creatorcontrib><creatorcontrib>Suliburk, James W., MD</creatorcontrib><title>Endovascular management of traumatic peripheral arterial injuries</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Abstract Background Traumatic injuries to peripheral arterial vessels are increasingly managed with endovascular techniques. Early small series have suggested that endovascular therapy is feasible and decreases operative blood loss, but these data are limited. The purpose of this study was to evaluate the feasibility and outcomes of endovascular management of nonaortic arterial trauma. Materials and methods We reviewed records of traumatic nonaortic arterial injuries presenting at an urban level 1 trauma center from December 2009–July 2013. Patients undergoing treatment in interventional radiology and patients whose injuries occurred >72 h before presentation were excluded. Demographics, indicators of injury severity, operative blood loss, transfusion requirements, and clinical outcome were compared between patients undergoing endovascular and open management using appropriate inferential statistics. Results During the study period, 17 patients underwent endovascular interventions and 20 had open surgery. There were 19 upper extremity and/or thoracic outlet arterial injuries, 15 lower extremity injuries and 11 pelvic injuries. Endovascular cases were completed using a vascular imaging C-arm in a standard operating room. Estimated blood loss during the primary procedure was significantly lower with endovascular management (150 versus 825 cc, P < 0.001). No differences were observed between cohorts in age, injury severity score, intensive care unit length of stay, arterial pH, transfusion requirements, inpatient complication rate, or mortality. Conclusions Our experience with endovascular management demonstrates its feasibility with commonly available tools. Operative blood loss may be significantly decreased using endovascular techniques. Further study is needed to refine patient selection criteria and to define long-term outcomes.</description><subject>Adult</subject><subject>Arterial trauma</subject><subject>Arteries - injuries</subject><subject>Arteries - surgery</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Endovascular Procedures - statistics & numerical data</subject><subject>Endovascular therapy</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative blood loss</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Texas - epidemiology</subject><subject>Treatment Outcome</subject><subject>Vascular System Injuries - surgery</subject><subject>Young Adult</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtLHUEQhZsQiTcmPyAbmWU2M1b1Yx4IglxMFAQX6rrp212T9GQe1-4ZwX-fHq66yCKrqoJzDtR3GPuGUCBgedYVXYwFB1QFyALq8gPbIDQqr8tKfGQbAM5zWYM8Zp9j7CDdTSU-sWNeIqoamg27vBrd9GyiXXoTssGM5hcNNM7Z1GZzMMtgZm-zPQW__03B9JkJczrS4sduCZ7iF3bUmj7S19d5wh5_XD1sr_Pbu58328vb3CpZzzlax1sunaGmla2VVoBzbWmsq3Z1ta41Wt46h8IIK5VACbuSGix3KBpRiRP2_ZC7D9PTQnHWg4-W-t6MNC1RYyWwqpWoZJLiQWrDFGOgVu-DH0x40Qh6Jac7ncjplZwGqRO55Dl9jV92A7l3xxuqJDg_CCg9-ewp6Gg9jZacD2Rn7Sb_3_iLf9y296O3pv9DLxS7aQljoqdRR65B36_Vrc2hAlBcKPEXUuaUeg</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Scott, Aaron R., MD</creator><creator>Gilani, Ramyar, MD</creator><creator>Tapia, Nicole M., MD</creator><creator>Mattox, Kenneth L., MD</creator><creator>Wall, Matthew J., MD</creator><creator>Suliburk, James W., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1210-3731</orcidid></search><sort><creationdate>20151201</creationdate><title>Endovascular management of traumatic peripheral arterial injuries</title><author>Scott, Aaron R., MD ; Gilani, Ramyar, MD ; Tapia, Nicole M., MD ; Mattox, Kenneth L., MD ; Wall, Matthew J., MD ; Suliburk, James W., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c548t-1cd2f24dae9f4fc4c30ddf6acd7b87ddf681c2fdd13a3c453140b6e916b139373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Arterial trauma</topic><topic>Arteries - injuries</topic><topic>Arteries - surgery</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Endovascular Procedures - statistics & numerical data</topic><topic>Endovascular therapy</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative blood loss</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Texas - epidemiology</topic><topic>Treatment Outcome</topic><topic>Vascular System Injuries - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scott, Aaron R., MD</creatorcontrib><creatorcontrib>Gilani, Ramyar, MD</creatorcontrib><creatorcontrib>Tapia, Nicole M., MD</creatorcontrib><creatorcontrib>Mattox, Kenneth L., MD</creatorcontrib><creatorcontrib>Wall, Matthew J., MD</creatorcontrib><creatorcontrib>Suliburk, James W., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scott, Aaron R., MD</au><au>Gilani, Ramyar, MD</au><au>Tapia, Nicole M., MD</au><au>Mattox, Kenneth L., MD</au><au>Wall, Matthew J., MD</au><au>Suliburk, James W., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endovascular management of traumatic peripheral arterial injuries</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>199</volume><issue>2</issue><spage>557</spage><epage>563</epage><pages>557-563</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>Abstract Background Traumatic injuries to peripheral arterial vessels are increasingly managed with endovascular techniques. Early small series have suggested that endovascular therapy is feasible and decreases operative blood loss, but these data are limited. The purpose of this study was to evaluate the feasibility and outcomes of endovascular management of nonaortic arterial trauma. Materials and methods We reviewed records of traumatic nonaortic arterial injuries presenting at an urban level 1 trauma center from December 2009–July 2013. Patients undergoing treatment in interventional radiology and patients whose injuries occurred >72 h before presentation were excluded. Demographics, indicators of injury severity, operative blood loss, transfusion requirements, and clinical outcome were compared between patients undergoing endovascular and open management using appropriate inferential statistics. Results During the study period, 17 patients underwent endovascular interventions and 20 had open surgery. There were 19 upper extremity and/or thoracic outlet arterial injuries, 15 lower extremity injuries and 11 pelvic injuries. Endovascular cases were completed using a vascular imaging C-arm in a standard operating room. Estimated blood loss during the primary procedure was significantly lower with endovascular management (150 versus 825 cc, P < 0.001). No differences were observed between cohorts in age, injury severity score, intensive care unit length of stay, arterial pH, transfusion requirements, inpatient complication rate, or mortality. Conclusions Our experience with endovascular management demonstrates its feasibility with commonly available tools. Operative blood loss may be significantly decreased using endovascular techniques. Further study is needed to refine patient selection criteria and to define long-term outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26115809</pmid><doi>10.1016/j.jss.2015.04.086</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1210-3731</orcidid></addata></record> |
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| subjects | Adult Arterial trauma Arteries - injuries Arteries - surgery Blood Loss, Surgical - statistics & numerical data Endovascular Procedures - statistics & numerical data Endovascular therapy Feasibility Studies Female Humans Male Middle Aged Operative blood loss Postoperative Complications - epidemiology Retrospective Studies Surgery Texas - epidemiology Treatment Outcome Vascular System Injuries - surgery Young Adult |
| title | Endovascular management of traumatic peripheral arterial injuries |
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