Endovascular Instead of Open Surgical Repair of Axillosubclavian Artery Injuries: An Evolving Paradigm Shift
Author
Jalali, ShreyaRoberts, Derek J.
Brenner, Megan L.
Dubose, Joseph J.
Moore, Laura J.
Power, Adam H.
Date
2021-01-11Journal
Journal of Endovascular Resuscitation and Trauma ManagementPublisher
Orebro University HospitalType
Article
Metadata
Show full item recordAbstract
Axillosubclavian injuries (ASI) comprise a small proportion of vascular injuries, yet their morbidity and mortality is high. This is often attributable to non-compressible bleeding in the apical thorax, hemodynamic instability, and the anatomically challenging location of these vessels making them difficult to access and control quickly. While the traditional management of ASI was with open surgical repair, recent years have seen an evolution towards less invasive endovascular repair (EVR). In patients with these injuries, EVR may be a safer alternative that achieves similar immediate results with significantly lower complication and mortality rates than the highly morbid open surgical option. In this article, we review and compare the two approaches, providing an overview of patient selection, anatomic considerations, techniques, postoperative management, and outcomes. With the advent of endovascular trauma management and more trauma team members capable of endovascular management of vascular trauma, a paradigm shift towards EVR for ASI is taking place. © 2021 CC BY-NC 4.0 – in cooperation with Depts. of Cardiothoracic/Vascular Surgery, General Surgery and Anesthesia, Örebro University Hospital and Örebro University, Sweden.Identifier to cite or link to this item
http://hdl.handle.net/10713/18048ae974a485f413a2113503eed53cd6c53
10.26676/jevtm.v5i3.227