Endovascular therapy for the treatment of arterial trauma

Several factors may limit the success of conventional operative therapy for traumatic arterial injuries. In particular, the inaccessibility of the vascular lesion, anatomic distortion, and the inherent problems associated with operating in a traumatized and often contaminated field are among these limiting factors. As a result, endovascular therapy has emerged as an important potential alternative. This paper focuses on the application of endovascular therapy to the trauma patient, based on our experience and those previously published by other groups. Injuries to the carotid, femoral, axillary/subclavian and iliac arteries, as well as to the abdominal and thoracic aorta, have been successfully managed by stent-grafting. Despite the potential benefits of this mode of therapy, its long-term utility will depend on our ability to overcome certain limitations associated with the technique, and on careful patient selection.