Endovascular Repair of Blunt Popliteal Arterial Injuries

Zhong, Songfa; Zhang, Xiquan; Chen, Zhong; Dong, Peng; Sun, Yu; Wei, Zhu; Pan, Xiaolin; Qi, Deming

doi:10.3348/kjr.2016.17.5.789

Cited by 19 publications

(5 citation statements)

References 40 publications

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“…108 Covered stents, including the Viabahn (W. L. Gore & Associates, Inc), 111,112 Fluency (Bard), 92,107,113 Jostent (Abbott), 111 iCast (Atrium), 114 WALLGRAFT (Boston Scientific, Inc), 115 and Passager (Boston Scientific) 116 have been described to treat occlusions, transections, pseudoaneurysms, extravasation, and AC fistulas. Bare metal stents, including the Xceed (Abbott) 69 and Lifestent (Bard) 109 have been used to treat transections and pseudoaneurysms.…”

Section: Lower Extremitymentioning

confidence: 99%

“…Popliteal stents are beginning to see use in popliteal aneurysms, 106 with the suggestion that they may be equivalent to open bypass. Justifications for pursuing endovascular rather than open repair for popliteal injuries in blunt, penetrating, and iatrogenic trauma include a concomitant, vertical incision for orthopedic procedures, 107 concern for placing prosthetic into a contaminated wound, 108 desire to decrease time to revascularization, 109 or tissue disruption due to trauma. 110 Devices and techniques use vary.…”

Section: Poplitealmentioning

confidence: 99%

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Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

Glaser

Kalapatapu

2019

Vasc Endovascular Surg

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Objective: To review the current use of endovascular techniques in trauma. Summary Background Data: Multiple studies have demonstrated that, despite current guidelines, endovascular therapies are used in instances of arterial trauma. Methods: The existing literature concerning arterial trauma was reviewed. Studies reviewed included case reports, single-center case series, large database studies, official industry publications and instructions for use, and society guidelines. Results: Endovascular therapies are used in arterial trauma in all systems. The use of thoracic endografts in blunt thoracic aortic trauma is accepted and endorsed by society guidelines. The use of endovascular therapies in other anatomic locations is largely limited to single-center studies. Advantages potentially include less morbidity due to smaller incisions as well as shorter operating room times. Many report using endovascular therapies even with hard signs of injury. Long-term results are limited by a lack of long-term follow-up but, in general, suggest that these techniques produce acceptable outcomes. The adoption of these techniques may be limited by resource and surgeon availability. Conclusions: The use of endovascular therapies in trauma has gained acceptance despite not yet having a place in official guidelines.

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Section: Lower Extremitymentioning

confidence: 99%

Section: Poplitealmentioning

confidence: 99%

Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

Glaser

Kalapatapu

2019

Vasc Endovascular Surg

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“…Stent patency rates were 75.3% at 12 months, 61.9% at 24 months, and 55.7% at 48 months. Similarly, Zhong et al reported in-stent thrombosis in one out of seven patients who underwent endovascular stenting to the popliteal artery at 18 months following the initial injury [ 15 ]. Although in-stent thrombosis appeared higher in these patients, most of these complications were amenable to endovascular recannulation.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Repair of a Traumatic Popliteal Artery Injury

Nguyen¹,

Tiziano²,

Beckermann³

et al. 2022

Cureus

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In patients who sustain a traumatic arterial injury to the lower extremities, timely intervention is key for limb salvage. Traditionally, patients with a popliteal injury have undergone an open surgical bypass but, in recent years, endovascular repair has become more frequent. We present the case of a 46-year-old male who sustained a right tibial/fibular fracture and an associated popliteal artery injury during a pedestrian versus car accident. At presentation, distal signals were not detectable on duplex ultrasonography, and computed tomography confirmed an occlusion of the P3 popliteal artery and proximal anterior tibial and tibioperoneal trunk, as well as a comminuted tibia and fibula fracture. He also had a subdural hematoma without midline shift. He was taken to the operating room emergently and, following external fixation of the tibial/fibular fracture, he underwent angiography of the right leg. There was no thrombus or extravasation but a static column of blood secondary to a flow-limiting intimal flap was present, and an endovascular repair of the popliteal artery with balloon angioplasty and Tack stents (Intact Vascular, Wayne, PA) was pursued. Heparin was not utilized due to the patient's intracranial hemorrhage. On hospital day four, he underwent internal fixation of the tibial/fibular fracture. The subarachnoid/subdural hematoma remained stable and a prophylactic dose of rivaroxaban and aspirin was started. The patient recovered well from these procedures and was discharged 16 days after the accident.

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“…This may be especially true in regions where open surgery would cause iatrogenic complications (5). Endovascular interventions in extremity trauma have been associated (19,23,24). Iliac artery injuries can be quite severe and are associated with significant mortality rates upwards of 40% (25), necessitating the need for rapid intervention.…”

Section: Endovascular Techniques In Extremity Traumamentioning

confidence: 99%

Endovascular interventions in the management of acute extremity trauma: a narrative review

et al. 2021

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Minimally invasive endovascular interventions including stenting and embolization have been widely adopted for the treatment of emergent and traumatic thoracoabdominal injuries. In recent years, these techniques have been utilized in the setting of extremity vascular trauma with promising outcomes. By allowing for the rapid diagnosis and subsequent treatment of penetrating or blunt vascular extremity trauma, these techniques can help to minimize blood loss, reduce operative complications, and potentially prevent limb amputation. Here, we present a narrative review of the ever-increasing role of minimally invasive interventions in the management of extremity trauma and compare its use and outcomes to open surgical repair. A special focus is placed on diagnostic imaging modalities in trauma and the role of interventional radiologists in the work-up and treatment of extremity trauma. We discuss diagnostic imaging modalities that aid in the triaging of extremity trauma, such as Doppler sonography, CT angiography, and catheterbased angiography. We present an overview on the literature related to endovascular interventions such as embolotherapy and stent grafting as well as the technical challenges associated with each technique. Finally, we present our own cases on the workup and endovascular treatment of extremity trauma, including CT angiography, particulate and coil embolization, and stent graft placement.

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Endovascular Repair of Blunt Popliteal Arterial Injuries

Cited by 19 publications

References 40 publications

Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

Endovascular Repair of a Traumatic Popliteal Artery Injury

Endovascular interventions in the management of acute extremity trauma: a narrative review

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