Endovascular therapy in trauma.

Area of Science:

• Vascular Surgery
• Trauma Management
• Interventional Radiology

Background:

• Endovascular techniques have revolutionized vascular disease management over 15 years.
• These minimally invasive methods offer reduced morbidity and mortality compared to open surgery.
• Endovascular approaches are increasingly adopted in trauma care.

Purpose of the Study:

• To review current endovascular techniques for managing vascular injury, bleeding, and shock in trauma.
• To categorize endovascular trauma management into large-vessel repair, hemostasis, and balloon occlusion.
• To assess established and evolving endovascular applications in severe trauma scenarios.

Main Methods:

• Review of endovascular techniques categorized by application: large-vessel repair, mid- to small-vessel hemostasis, and large-vessel balloon occlusion.
• Framework for endovascular inventory and performance in trauma settings.
• Appraisal of established and nascent endovascular scenarios in severe injury.

Main Results:

• Endovascular methods are effective for large-vessel repair (e.g., covered stents).
• Mid- to small-vessel bleeding is managed with coils, plugs, and hemostatic agents.
• Resuscitative endovascular balloon occlusion of the aorta aids in resuscitation for severe shock.

Conclusions:

• Endovascular techniques provide crucial, less invasive options for trauma patients with vascular injuries, bleeding, and shock.
• A structured approach to endovascular inventory and technique selection is beneficial in trauma care.
• Continued advancements in technology and acceptance will further expand the role of endovascular interventions in trauma.