McPherson Simon J
Department of Radiology, Leeds General Infirmary, Leeds, United Kingdom.
Semin Intervent Radiol. 2007 Jun;24(2):180-96. doi: 10.1055/s-2007-980042.
Interventional radiologists (IRs) now play a major role in the management of thoracic aortic and great vessel trauma. The recent availability of a wide range of stent grafts able to treat vessels from 3 to 46 mm in diameter is clearly a significant contributor to this change. Stent grafts can now treat the majority of incomplete aortic injuries with much lower morbidity and mortality than open surgery. Short- to medium-term follow-up is encouraging, but the long-term durability is unknown, and close monitoring of these patients must continue. In great vessel trauma, stent grafts are a useful adjunct to balloon tamponade, embolization, and bare stents. As a result, a wide range of head neck and upper limb vascular injuries can be managed with less local trauma, blood loss, and physiological stress. The increased involvement of IR in the management of vascular trauma is not simply the result of technological advances. IRs have increasingly made themselves available to carry out these emergency procedures. IRs should assist in the development of trauma protocols and management algorithms that involve endovascular expertise early in the assessment of the major trauma patient.
介入放射科医生（IRs）目前在胸主动脉和大血管创伤的管理中发挥着重要作用。最近能够治疗直径3至46毫米血管的多种支架移植物的出现显然是这一变化的重要促成因素。与开放手术相比，支架移植物现在可以治疗大多数不完全性主动脉损伤，且发病率和死亡率要低得多。短期至中期随访结果令人鼓舞，但长期耐久性尚不清楚，必须继续密切监测这些患者。在大血管创伤中，支架移植物是球囊填塞、栓塞和裸支架的有用辅助手段。因此，一系列头颈部和上肢血管损伤可以通过更少的局部创伤、失血和生理应激来处理。IRs在血管创伤管理中参与度的增加不仅仅是技术进步的结果。IRs越来越愿意开展这些急诊手术。IRs应协助制定创伤治疗方案和管理算法，在对主要创伤患者的评估早期就纳入血管内专业知识。
