Over the past several decades, catheter-based and endovascular techniques have been used with increasing frequency for the management of trauma. This is particularly true for the management of solid organ injury and vascular injuries resulting from pelvic fracture with the use of embolization techniques for successful arrest of active hemorrhage. Likewise, there is a large body of literature regarding the management of acute traumatic vascular injuries involving traditional open surgical techniques. Currently, however, there is sparse literature on the management of vascular trauma with endovascular techniques. The endovascular management of vascular trauma seems particularly appealing in the management of blunt truncal injuries, especially in the setting of severe concomitant brain and lung injury. Extremity and neck injuries are probably best handled by traditional methods of surgical proximal and distal control, the exception to this being base of skull injuries where there is no ability for distal vessel control, and “watershed” areas between the trunk and extremities where proximal vascular control can be quite difficult. This chapter reviews current literature with regard to the endovascular management of traumatic vascular injuries with regions being broadly defined as neck, trunk, and extremity.
Mattox KL, Feliciano DV, Burch J, Beall AC, Jr., Jordan GL, Jr., De Bakey ME.Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epidemiologic evolution 1958 to 1987. Ann Surg.1989; 209(6): 698-705.
2.
Beitsch P, Weigelt JA, Flynn E, Easley S.Physical examination and arteriography in patients with penetrating zone II neck wounds. Arch Surg.1994;129(6): 577-581.
3.
Demetriades D, Charalambides D, Lakhoo M.Physical examination and selective conservative management in patients with penetrating injuries of the neck. Br J Surg.1993;80(12): 1534-1536.
4.
Sanabria A, Jimenez CM.Endovascular management of an exsanguinating wound of the right internal jugular vein in zone III of the neck: case report. J Trauma.2003;55(1): 158-161.
5.
Ramadan F, Rutledge R, Oller D, Howell P, Baker C, Keagy B.Carotid artery trauma: a review of contemporary trauma center experiences. J Vasc Surg.1995; 21(1): 46-55.
6.
Fabian TC, Patton JH, Jr., Croce MA, Minard G, Kudsk KA, Pritchard FE.Blunt carotid injury. Importance of early diagnosis and anticoagulant therapy. Ann Surg.1996;223(5): 513-522.
Biffl WL, Moore EE, Ryu RK, Offner PJ, Novak Z, Coldwell DM, et al.The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurologic outcome. Ann Surg.1998;228(4): 462-470.
9.
Pretre R, Kursteiner K, Reverdin A, Faidutti B.Blunt carotid artery injury: devastating consequences of undetected pseudoaneurysm. J Trauma.1995;39(5): 1012-1014.
10.
Duke BJ, Ryu RK, Coldwell DM, Brega KE.Treatment of blunt injury to the carotid artery by using endovascular stents: an early experience. J Neurosurg.1997;87(6): 825-829.
11.
Horowitz MB, Miller G, III, Meyer Y, Carstens G, III, Purdy PD.Use of intravascular stents in the treatment of internal carotid and extracranial vertebral artery pseudoaneurysms. AJNR.1996;17(4): 693-696.
12.
Liu AY, Paulsen RD, Marcellus ML, Steinberg GK, Marks MP.Long-term outcomes after carotid stent placement treatment of carotid artery dissection. Neurosurgery.1999;45(6): 1368-1373.
13.
Parodi JC, Schonholz C, Ferreira LM, Bergan J.Endovascular stent-graft treatment of traumatic arterial lesions. Ann Vasc Surg.1999;13(2): 121-129.
14.
Coldwell DM, Novak Z, Ryu RK, Brega KE, Biffl WL, Offner PJ, et al.Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents. J Trauma.2000;48(3): 470-472.
Ellis PK, Kennedy PT, Barros D’Sa AA.Successful exclusion of a high internal carotid pseudoaneurysm using the Wallgraft endoprosthesis. Cardiovasc Intervent Radiol.2002;25(1): 68-69.
17.
McNeil JD, Chiou AC, Gunlock MG, Grayson DE, Soares G, Hagino RT.Successful endovascular therapy of a penetrating zone III internal carotid injury. J Vasc Surg.2002;36(1): 187-190.
18.
Wyers MC, Powell RJ.Management of carotid injuries in a hostile neck using endovascular grafts. J Vasc Surg.2004;39(6): 1335-1339.
19.
Cohen JE, Ben-Hur T, Rajz G, Umansky F, Gomori JM.Endovascular stent-assisted angioplasty in the management of traumatic internal carotid artery dissections. Stroke.2005;36(4): e45-e47.
20.
Kerby JD, May AK, Gomez CR, Rue LW, III.Treatment of bilateral blunt carotid injury using percutaneous angioplasty and stenting: case report and review of the literature. J Trauma.2000;49(4): 784-787.
Yee LF, Olcott EW, Knudson MM, Lim RC, Jr.Extraluminal, transluminal, and observational treatment for vertebral artery injuries. J Trauma.1995;39(3): 480-484.
27.
Jamieson WR, Janusz MT, Gudas VM, Burr LH, Fradet GJ, Henderson C.Traumatic rupture of the thoracic aorta: third decade of experience. Am J Surg.2002; 183(5): 571-575.
28.
Von Oppell UO, Dunne TT, De Groot MK, Zilla P.Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia. Ann Thorac Surg.1994;58(2): 585-593.
29.
Kasirajan K, Heffernan D, Langsfeld M.Acute thoracic aortic trauma: a comparison of endoluminal stent grafts with open repair and nonoperative management. Ann Vasc Surg.2003;17(6): 589-595.
30.
Cowley RA, Turney SZ, Hankins JR, Rodriguez A, Attar S, Shankar BS.Rupture of thoracic aorta caused by blunt trauma. A fifteen-year experience. J Thorac Cardiovasc Surg.1990;100(5): 652-660.
31.
Fabian TC, Richardson JD, Croce MA, et al.Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma. J Trauma.1997;42(3): 374-380.
32.
Semba CP, Kato N, Kee ST, et al.Acute rupture of the descending thoracic aorta: repair with use of endovascular stent-grafts. J Vasc Interv Radiol.1997;8(3): 337-342.
33.
Kato N, Dake MD, Miller DC, et al.Traumatic thoracic aortic aneurysm: treatment with endovascular stent-grafts. Radiology.1997;205(3): 657-662.
34.
Mitchell RS, Miller DC, Dake MD, Semba CP, Moore KA, Sakai T.Thoracic aortic aneurysm repair with an endovascular stent graft: the “first generation.”Ann Thorac Surg.1999;67(6): 1971-1974.
35.
Dake MD, Miller DC, Mitchell RS, Semba CP, Moore KA, Sakai T.The “first generation” of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta. J Thorac Cardiovasc Surg.1998; 116(5): 689-703.
Doss M, Balzer J, Martens S, Wood JP, et al.Surgical versus endovascular treatment of acute thoracic aortic rupture: a single-center experience. Ann Thorac Surg.2003;76(5): 1465-1469.
Fujikawa T, Yukioka T, Ishimaru S, et al.Endovascular stent grafting for the treatment of blunt thoracic aortic injury. J Trauma.2001;50(2): 223-229.
41.
Gorich J, Asquan Y, Seifarth H, et al.Initial experience with intentional stent-graft coverage of the subclavian artery during endovascular thoracic aortic repairs. J Endovasc Ther.2002;9Suppl 2: II39-II43.
42.
Karmy-Jones R, Hoffer E, Meissner MH, Nicholls S, Mattos M.Endovascular stent grafts and aortic rupture: a case series. J Trauma.2003;55(5): 805-810.
43.
Marty-Ane CH, Berthet JP, Branchereau P, Mary H, Alric P.Endovascular repair for acute traumatic rupture of the thoracic aorta. Ann Thorac Surg.2003;75(6): 1803-1807.
44.
Morishita K, Kurimoto Y, Kawaharada N, et al.Descending thoracic aortic rupture: role of endovascular stent-grafting. Ann Thorac Surg.2004;78(5): 1630-1634.
45.
Orford VP, Atkinson NR, Thomson K, et al.Blunt traumatic aortic transection: the endovascular experience. Ann Thorac Surg.2003;75(1): 106-111.
46.
Ott MC, Stewart TC, Lawlor DK, Gray DK, Forbes TL.Management of blunt thoracic aortic injuries: endovascular stents versus open repair. J Trauma.2004;56(3): 565-570.
47.
Peterson BG, Matsumura JS, Morasch MD, West MA, Eskandari MK.Percutaneous endovascular repair of blunt thoracic aortic transection. J Trauma.2005;59(5): 1062-1065.
48.
Ruchat P, Capasso P, Chollet-Rivier M, Marty B, Von Segesser LK.Endovascular treatment of aortic rupture by blunt chest trauma. J Cardiovasc Surg (Torino).2001;42(1): 77-81.
49.
Stampfl P, Greitbauer M, Zimpfer D, et al.Mid-term results of conservative, conventional and endovascular treatment for acute traumatic aortic lesions. Eur J Vasc Endovasc Surg.2006;31(5): 475-480.
50.
Lachat M, Pfammatter T, Witzke H, et al.Acute traumatic aortic rupture: early stent-graft repair. Eur J Cardiothorac Surg.2002;21(6): 959-963.
51.
Thompson CS, Rodriguez JA, Ramaiah VG, et al.Acute traumatic rupture of the thoracic aorta treated with endoluminal stent grafts. J Trauma.2002;52(6): 1173-1177.
52.
Scheinert D, Krankenberg H, Schmidt A, et al.Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta. Eur Heart J.2004;25(8): 694-700.
Wellons ED, Milner R, Solis M, Levitt A, Rosenthal D.Stent-graft repair of traumatic thoracic aortic disruptions. J Vasc Surg.2004;40(6): 1095-1100.
55.
Rousseau H, Dambrin C, Marcheix B, et al.Acute traumatic aortic rupture: a comparison of surgical and stent-graft repair. J Thorac Cardiovasc Surg.2005;129(5): 1050-1055.
56.
Cook J, Salerno C, Krishnadasan B, Nicholls S, Meissner M, Karmy-Jones R.The effect of changing presentation and management on the outcome of blunt rupture of the thoracic aorta. J Thorac Cardiovasc Surg.2006;131(3): 594-600.
57.
Fattori R, Napoli G, Lovato L, et al.Indications for, timing of, and results of catheter-based treatment of traumatic injury to the aorta. AJR.2002;179(3): 603-609.
58.
Fattori R, Napoli G, Lovato L, et al.Indications for, timing of, and results of catheter-based treatment of traumatic injury to the aorta. AJR.2002;179(3): 603-609.
59.
Starnes BW.Endograft collpase leading to paraplegia in a patient undergoing repair of blunt aortic injury. J Vasc Surg.2006. In press.
60.
Duhaylongsod FG, Glower DD, Wolfe WG.Acute traumatic aortic aneurysm: the Duke experience from 1970 to 1990. J Vasc Surg.1992;15(2): 331-342.
61.
Mattison R, Hamilton IN, Jr., Ciraulo DL, Richart CM.Stent-graft repair of acute traumatic thoracic aortic transection with intentional occlusion of the left subclavian artery: case report. J Trauma.2001;51(2): 326-328.
62.
Steinbauer MG, Stehr A, Pfister K, et al.Endovascular repair of proximal endograft collapse after treatment for thoracic aortic disease. J Vasc Surg.2006;43(3): 609-612.
63.
Fang TD, Peterson DA, Kirilcuk NN, Dicker RA, Spain DA, Brundage SI.Endovascular management of a gunshot wound to the thoracic aorta. J Trauma.2006;60(1): 204-208.
64.
Lin PH, Bush RL, Zhou W, Peden EK, Lumsden AB.Endovascular treatment of traumatic thoracic aortic injury—should this be the new standard of treatment? J Vasc Surg. 2006;43Suppl A: 22A-29A.
65.
Lock JS, Huffman AD, Johnson RC.Blunt trauma to the abdominal aorta. J Trauma.1987;27(6): 674-677.
66.
Reisman JD, Morgan AS.Analysis of 46 intra-abdominal aortic injuries from blunt trauma: case reports and literature review. J Trauma.1990;30(10): 1294-1297.
67.
Lassonde J, Laurendeau F.Blunt injury of the abdominal aorta. Ann Surg.1981;194(6): 745-748.
68.
Berthet JP, Marty-Ane CH, Veerapen R, Picard E, Mary H, Alric P.Dissection of the abdominal aorta in blunt trauma: Endovascular or conventional surgical management? J Vasc Surg2003;38(5): 997-1003.
69.
Brunsting LA, Ouriel K.Traumatic fracture of the abdominal aorta. Rupture of a calcified abdominal aorta with minimal trauma. J Vasc Surg.1988;8(2): 184-186.
70.
Picard E, Marty-Ane CH, Vernhet H, Sessa C, Lesnik A, Senac JP, et al.Endovascular management of traumatic infrarenal abdominal aortic dissection. Ann Vasc Surg.1998;12(6): 515-521.
71.
Vernhet H, Marty-Ane CH, Lesnik A, et al.Dissection of the abdominal aorta in blunt trauma: management by percutaneous stent placement. Cardiovasc Intervent Radiol.1997;20(6): 473-476.
Fontaine AB, Nicholls SC, Borsa JJ, Hoffer E, Bloch RD, Kohler T.Seat belt aorta: endovascular management with a stent-graft. J Endovasc Ther.2001;8(1): 83-86.
74.
Teruya TH, Bianchi C, Abou-Zamzam AM, Ballard JL.Endovascular treatment of a blunt traumatic abdominal aortic injury with a commercially available stent graft. Ann Vasc Surg.2005;19(4): 474-478.
75.
Villas PA, Cohen G, Putnam SG, III, Goldberg A, Ball D.Wallstent placement in a renal artery after blunt abdominal trauma. J Trauma.1999;46(6): 1137-1139.
76.
Whigham CJ, Jr., Bodenhamer JR, Miller JK.Use of the Palmaz stent in primary treatment of renal artery intimal injury secondary to blunt trauma. J Vasc Interv Radiol.1995;6(2): 175-178.
77.
Lee JT, White RA.Endovascular management of blunt traumatic renal artery dissection. J Endovasc Ther2002; 9(3): 354-358.
Sprouse LR, Hamilton IN, Jr.The endovascular treatment of a renal arteriovenous fistula: placement of a covered stent. J Vasc Surg.2002;36(5): 1066-1068.
81.
Carrillo EH, Spain DA, Wilson MA, Miller FB, Richardson JD.Alternatives in the management of penetrating injuries to the iliac vessels. J Trauma.1998; 44(6): 1024-1029.
82.
Burch JM, Richardson RJ, Martin RR, Mattox KL.Penetrating iliac vascular injuries: recent experience with 233 consecutive patients. J Trauma.1990;30(12): 1450-1459.
83.
Tsai FC, Wang CC, Fang JF, et al.Isolated common iliac artery occlusion secondary to atherosclerotic plaque rupture from blunt abdominal trauma: case report and review of the literature. J Trauma.1997;42(1): 133-136.
84.
Lyden SP, Srivastava SD, Waldman DL, Green RM.Common iliac artery dissection after blunt trauma: case report of endovascular repair and literature review. J Trauma.2001;50(2): 339-342.
85.
Yeh MW, Horn JK, Schecter WP, Chuter TA, Lane JS.Endovascular repair of an actively hemorrhaging gunshot injury to the abdominal aorta. J Vasc Surg.2005; 42(5): 1007-1009.
86.
Burch JM, Feliciano DV, Mattox KL, Edelman M.Injuries of the inferior vena cava. Am J Surg.1988; 156(6): 548-552.
87.
Kuehne J, Frankhouse J, Modrall G, et al.Determinants of survival after inferior vena cava trauma. Am Surg.1999;65(10): 976-981.
88.
Castelli P, Caronno R, Piffaretti G, Tozzi M.Emergency endovascular repair for traumatic injury of the inferior vena cava. Eur J Cardiothorac Surg.2005;28(6): 906-908.
89.
Waldrop JL, Jr., Dart BW, Barker DE.Endovascular stent graft treatment of a traumatic aortocaval fistula. Ann Vasc Surg.2005;19(4): 562-565.
Becker GJ, Benenati JF, Zemel G, et al.Percutaneous placement of a balloon-expandable intraluminal graft for life-threatening subclavian arterial hemorrhage. J Vasc Interv Radiol.1991;2(2): 225-229.
92.
White R, Krajcer Z, Johnson M, Williams D, Bacharach M, O’Malley E.Results of a multicenter trial for the treatment of traumatic vascular injury with a covered stent. J Trauma.2006;60(6): 1189-1195.
93.
Wolma FJ, Larrieu AJ, Alsop GC.Arterial injuries of the legs associated with fractures and dislocations. Am J Surg.1980;140(6): 806-809.
94.
Lonn L, Delle M, Karlstrom L, Risberg B.Should blunt arterial trauma to the extremities be treated with endovascular techniques? J Trauma. 2005;59(5): 1224-1227.
95.
Maynar M, Baro M, Qian Z, et al.Endovascular repair of brachial artery transection associated with trauma. J Trauma.2004;56(6): 1336-1341.
96.
Risberg B, Lonn L.Management of vascular injuries using endovascular techniques. Eur J Surg.2000; 166(3): 196-201.
97.
Marin ML, Veith FJ, Panetta TF, et al.Percutaneous transfemoral insertion of a stented graft to repair a traumatic femoral arteriovenous fistula. J Vasc Surg.1993;18(2): 299-302.
98.
Lonn L, Olmarker A, Geterud K, et al.Treatment of femoral pseudoaneurysms. Percutaneous US-guided thrombin injection versus US-guided compression. Acta Radiol.2002;43(4): 396-400.
99.
Arena FJ.Arterial kink and damage in normal segments of the superficial femoral and popliteal arteries abutting nitinol stents—a common cause of late occlusion and restenosis? A single-center experience. J Invasive Cardiol.2005;17(9): 482-486.
100.
Lonn L, Olmarker A, Geterud K, Risberg B.Prospective randomized study comparing ultrasound-guided thrombin injection to compression in the treatment of femoral pseudoaneurysms. J Endovasc Ther.2004; 11(5): 570-576.
101.
Waigand J, Uhlich F, Gross CM, Thalhammer C, Dietz R.Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures. Catheter Cardiovasc Interv.1999;47(2): 157-164.
102.
Wilson JS, Miranda A, Johnson BL, Shames ML, Back MR, Bandyk DF.Vascular injuries associated with elective orthopedic procedures. Ann Vasc Surg.2003;17(6): 641-644.
103.
Rich NM, Hobson RW, Collins GJ, Jr.Traumatic arteriovenous fistulas and false aneurysms: a review of 558 lesions. Surgery.1975;78(6): 817-828.
104.
Jackson MR, Brengman ML, Rich NM.Delayed presentation of 50 years after a World War II vascular injury with intraoperative localization by duplex ultra-sound of a traumatic false aneurysm. J Trauma.1997; 43(1): 159-161.
105.
Yilmaz AT, Arslan M, Demirkilic U, et al.Missed arterial injuries in military patients. Am J Surg.1997;173(2): 110-114.
106.
Frykberg ER, Vines FS, Alexander RH.The natural history of clinically occult arterial injuries: a prospective evaluation. J Trauma.1989;29(5): 577-583.
107.
Edwards H, Martin E, Nowygrod R.Nonoperative management of a traumatic peroneal artery false aneurysm. J Trauma.1982;22(4): 323-326.
108.
Parodi JC.Endovascular repair of aortic aneurysms, arteriovenous fistulas, and false aneurysms. World J Surg.1996;20(6): 655-663.
109.
Rosa P, O’Donnell SD, Goff JM, Gillespie DL, Starnes B.Endovascular management of a peroneal artery injury due to a military fragment wound. Ann Vasc Surg.2003;17(6): 678-681.
110.
Toyota N, Kimura F, Yoshida S, et al.Peroneal artery aneurysm treated by transcatheter coil embolization and temporary balloon occlusion in Behcet’s disease. Cardiovasc Intervent Radiol.1999;22(3): 257-259.
111.
Champion HR, Bellamy RF, Roberts CP, Leppaniemi A.A profile of combat injury. J Trauma.2003;54(5 Suppl): S13-S19.
112.
Gawande A.Casualties of war—military care for the wounded from Iraq and Afghanistan. N Engl J Med.2004;351(24): 2471-2475.
113.
Nanobashvili J, Kopadze T, Tvaladze M, Buachidze T, Nazvlishvili G.War injuries of major extremity arteries. World J Surg.2003;27(2): 134-139.
114.
Starnes BW, Beekley AC, Sebesta JA, Andersen CA, Rush RM, Jr.Extremity vascular injuries on the battlefield: tips for surgeons deploying to war. J Trauma.2006;60(2): 432-442.
