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Semin intervent Radiol 2020; 37(01): 055-061
DOI: 10.1055/s-0039-3401840
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Penetrating Extremity Trauma Endovascular versus Open Repair?

Jeffery T. Kuwahara
1   Division of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, Chicago, Illinois
,
Ali Kord
1   Division of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, Chicago, Illinois
,
Charles E. Ray Jr.
1   Division of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, Chicago, Illinois
› Author Affiliations
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Publication History

Publication Date:
04 March 2020 (online)

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Abstract

Penetrating extremity trauma (PET) accounts for an estimated 5–15% of trauma with vascular injury and these injuries are accountable for a significant percentage of trauma-related deaths. Historically, vascular injuries were best treated by open repair. While a defined selection criteria and a comprehensive algorithm have not been validated, the advancement of endovascular techniques, embolotherapy, and stent grafting have become viable options for the treatment of penetrating arterial extremity trauma in select patients. Advantages endovascular repair offers include decreasing mortality and morbidity associated with open repair, decreasing blood loss, decreasing iatrogenic injury such as nerve injury, and lower rate of wound infection. Patients stability, type of vascular injury, and lesion location are main factors help deciding between endovascular and open repair. Patient selection between endovascular and open repair should be determined by on a case-by-case situation, individual hospital guidelines, a multidisciplinary approach, and technical expertise.

Keywords

penetrating extremity trauma - arterial trauma - vascular injury - endovascular repair

Financial interest

None declared.


 

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