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16.11.2016 | Review Article | Ausgabe 6/2016

European Journal of Trauma and Emergency Surgery 6/2016

Endovascular solutions for the management of penetrating trauma: an update on REBOA and axillo-subclavian injuries

Zeitschrift:
European Journal of Trauma and Emergency Surgery > Ausgabe 6/2016
Autoren:
B. C. Branco, J. J. DuBose

Abstract

Purpose

Endovascular procedures continue to gain acceptance as management options for penetrating traumatic injuries. Currently, several areas of potential endovascular application are being investigated. However, the bulk of the literature on this topic is still limited to case series or small retrospective studies. Therefore, we performed a review of the published experience involving the application of endovascular therapy to trauma patients who have sustained penetrating injuries with focus on outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) and endovascular repair of axillo-subclavian injuries.

Methods

Published case reports, retrospective and prospective studies of REBOA and axillo-subclavian injuries were systematically reviewed.

Results

A total of 7 studies on REBOA and 10 studies on endovascular repair of axillo-subclavian injuries were included. Overall, REBOA was used as an adjunct for hemorrhage control and resuscitation in patients at risk of cardiopulmonary arrest, preventing further cardiovascular collapse successfully. For axillo-subclavian injuries, endovascular stent placement had efficacy comparable to the traditional open repair.

Conclusion

REBOA is a safe and effective alternative to open thoracotomy in critically ill trauma patients at risk of death due to torso hemorrhage. Endovascular repair outcomes are comparable to open repair after axillo-subclavian injuries. Long-term results of endovascular repair remain to be defined in this patient population.

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