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    Endovascular Instead of Open Surgical Repair of Axillosubclavian Artery Injuries: An Evolving Paradigm Shift

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    Author
    Jalali, Shreya
    Roberts, Derek J.
    Brenner, Megan L.
    Dubose, Joseph J.
    Moore, Laura J.
    Power, Adam H.
    Date
    2021-01-11
    Journal
    Journal of Endovascular Resuscitation and Trauma Management
    Publisher
    Orebro University Hospital
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.26676/jevtm.v5i3.227
    Abstract
    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.
    Keyword
    Axillosubclavian
    Endovascular
    EVTM
    Vascular Trauma
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18048
    ae974a485f413a2113503eed53cd6c53
    10.26676/jevtm.v5i3.227
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