Endovascular treatment for traumatic injuries of the peripheral arteries following blunt trauma

Injury. 2007 Sep;38(9):1091-7. doi: 10.1016/j.injury.2007.02.044. Epub 2007 May 31.

Abstract

Objectives: The continued advances in imaging and stent/stent-graft technology have considerably expanded the indications for endovascular approach also in vascular trauma. We report our institutional experience with endovascular treatment of peripheral arterial injuries after blunt trauma.

Methods: Between January 2000 and June 2006 out of a series of 81 patients, 10 male patients (mean age of 50+/-14 years) with peripheral arterial injuries were managed endovascularly. At admission, haemorrhagic shock was present in three patients. Artery location involved common femoral (n=2), subclavian (n=2), axillary (n=2), external iliac (n=2), superficial femoral (n=1), and popliteal (n=1). Type of lesion was as follows: pseudoaneurysm (n=4), dissection (n=4), expanding haematoma (n=1), and arterio-venous fistula (n=1). Follow-up program included visit and duplex-ultrasonography, X-rays and/or spiral-computed tomography at 6-month interval during the first year, and yearly thereafter.

Results: The lesion was excluded in all cases. All patients survived. Major complications did not occur. Mean hospitalisation was 13 days. Limb-salvage was 100%. Follow-up ranged from 3 to 60 months (mean 16); a late occlusion of a popliteal stent-graft was managed with another endovascular procedure.

Conclusion: In our experience, endovascular treatment of vascular injuries after blunt trauma was feasible and effective.

MeSH terms

  • Adult
  • Arteries / injuries*
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Wounds, Nonpenetrating / therapy*