The effect of early endovascular intervention on the outcome of traumatic vascular injuries

Abstract

Background: In this study, we reported mid-term results of early endovascular treatment modalities for traumatic vascular injuries confirmed by angiography. Methods: Between January 2007 and December 2010, patients who were admitted to our clinic with gunshot injury or suspected penetrating/blunt injuries and suspected vascular injury were examined. After angiographic examination, 10 patients underwent endovascular treatment due to vascular injury. Vascular injuries were due to penetrating injury in three patients, gunshot injury in six patients and blunt trauma in one patient. Six patients presented with a pseudoaneurysm (two of which associated with arteriovenous fistula), three with rupture and one with axillary artery-to-bronchial fistula. Results: Coil embolization was performed in patients with arterial rupture. Stent graft implantation was performed in patients with pseudoaneurysm formation, arteriovenous or artery-to-bronchial fistula. All procedures were performed under local anesthesia. Symptoms related to vascular injury disappeared within postoperative three days and they were discharged on the postoperative fifth day. All patients were re-examined by color Doppler ultrasonography at three and 12 months. No findings of related extravasation, stenosis or ischemia were detected in the follow-up. Conclusion: Unnoticed vascular, traumatic or gunshot injuries may lead to limb dysfunction in the long-term. Angiographic evaluation of the vascular injury in suspected patients allows early treatment of vascular injuries. Endovascular treatment of vascular injuries in the same procedure is associated with less blood transfusion, shorter intensive care and in-hospital stay and lower mortality in patients with angiographically vascular injury.