Abstract No. 328: Emergency Endovascular Treatment of Isolated Vascular Injury of the Extremities with the Wallgraft Endoprosthesis

Abstract

PurposeTo present the safety, efficacy and follow-up of emergency endovascular treatment in extremity arterial trauma using the Wallgraft Endoprosthesis. Single-centre results.Materials & MethodsThirty patients were treated for hemorrhagic arterial trauma from September 2001 to June 2008.. Non procedural or systemic anticoagulation was employed. All patients underwent follow-up by physical examination and Doppler sonography. Patient's demographics, procedural techniques, complications, successes and failures were retrospectively evaluated.ResultsIatrogenic injuries accounted for 70% (21 out of 30) of injuries treated. The anatomic locations of injury were: iliac vessels 7 patients; femoral vessels 19 patients; Subclavian vessels 4 patients. Lesion type for treatment was rupture or perforation (n=18), acute pseudoaneurysm (n=11), AV fistulas (n=2), and dissections (n=3). All procedures were performed in the angiographic room under local anaesthesia. Immediate technical success was obtained in 30/30 patients (100%). One patient underwent a local thrombosis in puncture site at 48 hours. There were no device or procedure related deaths. At follow-up 6 critical ill patients died of their previous comorbidities (range 2-12 days; average 5 days). The remaining twenty four (80%) are alive with vessel injuries excluded and 100% primary vessel patency with a mean follow-up of 41.62 months (range 192-4 months).ConclusionWallgraft Endoprostheses and endovascular treatment of extremity arterial trauma are safe and efficient and they are a good alternative to conventional operative repair. PurposeTo present the safety, efficacy and follow-up of emergency endovascular treatment in extremity arterial trauma using the Wallgraft Endoprosthesis. Single-centre results. To present the safety, efficacy and follow-up of emergency endovascular treatment in extremity arterial trauma using the Wallgraft Endoprosthesis. Single-centre results. Materials & MethodsThirty patients were treated for hemorrhagic arterial trauma from September 2001 to June 2008.. Non procedural or systemic anticoagulation was employed. All patients underwent follow-up by physical examination and Doppler sonography. Patient's demographics, procedural techniques, complications, successes and failures were retrospectively evaluated. Thirty patients were treated for hemorrhagic arterial trauma from September 2001 to June 2008.. Non procedural or systemic anticoagulation was employed. All patients underwent follow-up by physical examination and Doppler sonography. Patient's demographics, procedural techniques, complications, successes and failures were retrospectively evaluated. ResultsIatrogenic injuries accounted for 70% (21 out of 30) of injuries treated. The anatomic locations of injury were: iliac vessels 7 patients; femoral vessels 19 patients; Subclavian vessels 4 patients. Lesion type for treatment was rupture or perforation (n=18), acute pseudoaneurysm (n=11), AV fistulas (n=2), and dissections (n=3). All procedures were performed in the angiographic room under local anaesthesia. Immediate technical success was obtained in 30/30 patients (100%). One patient underwent a local thrombosis in puncture site at 48 hours. There were no device or procedure related deaths. At follow-up 6 critical ill patients died of their previous comorbidities (range 2-12 days; average 5 days). The remaining twenty four (80%) are alive with vessel injuries excluded and 100% primary vessel patency with a mean follow-up of 41.62 months (range 192-4 months). Iatrogenic injuries accounted for 70% (21 out of 30) of injuries treated. The anatomic locations of injury were: iliac vessels 7 patients; femoral vessels 19 patients; Subclavian vessels 4 patients. Lesion type for treatment was rupture or perforation (n=18), acute pseudoaneurysm (n=11), AV fistulas (n=2), and dissections (n=3). All procedures were performed in the angiographic room under local anaesthesia. Immediate technical success was obtained in 30/30 patients (100%). One patient underwent a local thrombosis in puncture site at 48 hours. There were no device or procedure related deaths. At follow-up 6 critical ill patients died of their previous comorbidities (range 2-12 days; average 5 days). The remaining twenty four (80%) are alive with vessel injuries excluded and 100% primary vessel patency with a mean follow-up of 41.62 months (range 192-4 months). ConclusionWallgraft Endoprostheses and endovascular treatment of extremity arterial trauma are safe and efficient and they are a good alternative to conventional operative repair. Wallgraft Endoprostheses and endovascular treatment of extremity arterial trauma are safe and efficient and they are a good alternative to conventional operative repair.