Complex Liver Trauma With Bilhemia Treated With Perihepatic Packing and Endovascular Stent in the Vena Cava

Hommes, Martijn; Kazemier, Geert; Dijk, Lukas C. van; Kuipers, Ernst J.; Ijsseldijk, A. van; Vogels, L.M.M.; Schipper, I.B.

doi:10.1097/ta.0b013e318047c011

Cited by 14 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If filter retrieval was successful, subsequent IVC recanalization, angioplasty, and stent placement were performed if necessary to restore venous outflow in patients with symptomatic caval occlusion, and stent-graft placement was performed using previously described methods [10][11][12] if significant caval injury was identified. During preprocedure preparation, large-diameter stent grafts (Gore, Flagstaff, AZ) and an occlusion balloon (AGA Medical, Plymouth, MN) were made readily available in the procedure room.…”

Section: Methodsmentioning

confidence: 99%

Excimer Laser–Assisted Removal of Embedded Inferior Vena Cava Filters

Kuo

Odegaard

Rosenberg

et al. 2013

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

Background-Although chronically implanted inferior vena cava filters may result in filter-related morbidity, there is currently no routine option for removing such filters when they become firmly embedded along the vena cava endothelium. Methods and Results-During a 3-year period, 100 consecutive patients were prospectively enrolled in a single-center study. There were 42 men and 58 women (mean age, 46 years; limits, 18-76 years). Retrieval indications included filterrelated acute inferior vena cava thrombosis, chronic inferior vena cava occlusion, and pain from retroperitoneal or bowel penetration. Filter retrieval was also performed to prevent risks from prolonged implantation and to potentially eliminate the need for lifelong anticoagulation. After standard methods failed, photothermal tissue ablation was attempted with a laser sheath powered by a 308-nm xenon chloride excimer laser. Applied forces were recorded with a digital tension meter before and during laser activation. Laser-assisted retrieval was successful in 98.0% (95% confidence interval [CI], 93.0%-99.8%) with mean implantation of 855 days (limits, 37-6663 days; >18 years). The following filter types were encountered in this study: Günther-Tulip (n=34), Celect (n=12), Option (n=17), Optease (n=20, 1 failure), TrapEase (n=6, 1 failure), Simon-Nitinol (n=1), 12F Stainless Steel Greenfield (n=4), and Titanium Greenfield (n=6). The average force during failed standard retrievals was 7.2 versus 4.6 pounds during laser-assisted retrievals (P<0.0001). The major complication rate was 3.0% (95% CI, 0.6%-8.5%), the minor complication rate was 7.0% (95% CI, 0.3%-13.9%), and there were 4 adverse events (2 coagulopathic hemorrhages, 1 renal infarction, and 1 cholecystitis; 4.0%; 95% CI, 1.1%-9.9%) at mean follow-up of 500 days (limits, 84-1079 days). Scar tissue ablation was histologically confirmed in 96.0% (95% CI, 89.9%-98.9%). Successful retrieval allowed cessation of anticoagulation in 30 of 30 (100%) patients and alleviated morbidity in 23 of 24 patients (96%). Conclusions-Excimer laser-assisted removal is effective in removing embedded inferior vena cava filters refractory to standard retrieval and high force. This method can be safely used to prevent and alleviate filter-related morbidity. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01158482.

show abstract

Section: Methodsmentioning

confidence: 99%

Excimer Laser–Assisted Removal of Embedded Inferior Vena Cava Filters

Kuo

Odegaard

Rosenberg

et al. 2013

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

show abstract

“… 36 Biliary fistula can be treated by endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, achieving satisfactory results. 37 Batur et al 38 reported a possibility of hepatic artery pseudoaneurysm, which should be paid attention to in clinic.…”

Section: Postoperative Complications Of Hepatic Traumamentioning

confidence: 99%

Treatment strategy for hepatic trauma

Gong

2016

Chinese Journal of Traumatology

View full text Add to dashboard Cite

Liver is one of the organs with the highest injury rate, and in recent decades, the guidelines for the treatment of liver trauma have changed considerably. Now, there is a growing consensus that the most important step is diagnosis and depending upon the degree of severity, non-operative therapy is the main treatment method for hepatic trauma if conditions permit. For serious hepatic trauma patients such as those with hemodynamic instability, they should be operated upon as soon as possible. Regardless of the surgical options, doctors should control damage to patients and try to prevent complications. New therapies such as hepatic artery embolization and liver transplantation have been more and more used for the treatment of serious hepatic damage in clinics.

show abstract

“…When the injury is identified preoperatively, endovascular techniques will likely provide better salvage than open approaches. The use of endografts has been reported for treating retrohepatic IVC in conjunction with laparotomy ( 47 , 48 ), with adjunctive Pringle maneuver/packing and as a primary intervention alone ( 49 ) or combined with fenestrations for hepatic vein drainage ( 50 ). Such a strategy could be beneficial in cases of iatrogenic caval avulsions are anticipated in “hostile” abdomen elective surgery or in cases of suspected caval invasion by malignancy.…”

Section: Truncal Venous Injuriesmentioning

confidence: 99%

Management of Peripheral and Truncal Venous Injuries

Giannakopoulos

Avgerinos

2017

Front. Surg.

View full text Add to dashboard Cite

Civilian injuries are increasing according to the World Health Organization, and this is attributed mainly to road traffic accidents and urban interpersonal violence. Vascular injuries are common in these scenarios and are associated with high morbidity and mortality rates. Associated peripheral venous trauma is less likely to lead to death and controversy remains whether ligation or repair should be the primary approach. Conversely, non-compressible truncal venous insult can be lethal due to exsanguination, thus a high index of suspicion is crucial. Operative management is demanding with fair results but recent endovascular adjuncts demonstrate promising results and seem to be the way forward for these serious conditions.

show abstract

Complex Liver Trauma With Bilhemia Treated With Perihepatic Packing and Endovascular Stent in the Vena Cava

Cited by 14 publications

References 10 publications

Excimer Laser–Assisted Removal of Embedded Inferior Vena Cava Filters

Excimer Laser–Assisted Removal of Embedded Inferior Vena Cava Filters

Treatment strategy for hepatic trauma

Management of Peripheral and Truncal Venous Injuries

Contact Info

Product

Resources

About