Endovascular Therapy of Vascular Trauma-Current Options and Review of the Literature.

OBJECTIVE

To review the current use of endovascular techniques in trauma.

SUMMARY BACKGROUND DATA

Multiple studies have demonstrated that, despite current guidelines, endovascular therapies are used in instances of arterial trauma.

METHODS

The existing literature concerning arterial trauma was reviewed. Studies reviewed included case reports, single-center case series, large database studies, official industry publications and instructions for use, and society guidelines.

RESULTS

Endovascular therapies are used in arterial trauma in all systems. The use of thoracic endografts in blunt thoracic aortic trauma is accepted and endorsed by society guidelines. The use of endovascular therapies in other anatomic locations is largely limited to single-center studies. Advantages potentially include less morbidity due to smaller incisions as well as shorter operating room times. Many report using endovascular therapies even with hard signs of injury. Long-term results are limited by a lack of long-term follow-up but, in general, suggest that these techniques produce acceptable outcomes. The adoption of these techniques may be limited by resource and surgeon availability.

CONCLUSIONS

The use of endovascular therapies in trauma has gained acceptance despite not yet having a place in official guidelines.