Abou Ali Adham N, Salem Karim M, Alarcon Louis H, Bauza Graciela, Pikoulis Emmanuel, Chaer Rabih A, Avgerinos Efthymios D
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Division of Trauma and General Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Front Surg. 2017 Jul 20;4:39. doi: 10.3389/fsurg.2017.00039. eCollection 2017.
Experience with temporary intravascular shunts (TIVS) for vessel injury comes from the military sector and while the indications might be clear in geographically isolated and under resourced war zones, this may be an uncommon scenario in civilian trauma. Data supporting TIVS use in civilian trauma have been extrapolated from the military literature where it demonstrated improved life and limb salvage. Few non-comparative studies from the civilian literature have also revealed similar favorable outcomes. Still, TIVS placement in civilian vascular injuries is uncommon and by some debatable given the absence of clear indications for placement, the potential for TIVS-related complications, the widespread resources for immediate and definitive vascular repair, and the need for curtailing costs and optimizing resources. This article reviews the current evidence and the role of TIVS in contemporary civilian trauma management.
临时血管分流术(TIVS)用于血管损伤的经验来自军事领域。虽然在地理上孤立且资源匮乏的战区,其适应症可能很明确,但在 civilian trauma 中这可能是一种不常见的情况。支持 TIVS 在 civilian trauma 中应用的数据是从军事文献中推断出来的,军事文献表明它能提高生命和肢体挽救率。 civilian 文献中很少有非对比性研究也显示了类似的良好结果。尽管如此,TIVS 在 civilian 血管损伤中的应用并不常见,而且由于缺乏明确的放置指征、TIVS 相关并发症的可能性、广泛的即时和确定性血管修复资源,以及控制成本和优化资源的需求,其应用存在一定争议。本文回顾了当前的证据以及 TIVS 在当代 civilian trauma 管理中的作用。 注:“civilian trauma”直译为“平民创伤”,结合语境这里可理解为“ civilian trauma”指“ civilian trauma management”即“平民创伤管理”,但原文表述有些不清晰准确。