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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 6/2016

01-12-2016 | Review Article

Endovascular solutions for the management of penetrating trauma: an update on REBOA and axillo-subclavian injuries

Authors: B. C. Branco, J. J. DuBose

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2016

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Abstract

Purpose

Endovascular procedures continue to gain acceptance as management options for penetrating traumatic injuries. Currently, several areas of potential endovascular application are being investigated. However, the bulk of the literature on this topic is still limited to case series or small retrospective studies. Therefore, we performed a review of the published experience involving the application of endovascular therapy to trauma patients who have sustained penetrating injuries with focus on outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) and endovascular repair of axillo-subclavian injuries.

Methods

Published case reports, retrospective and prospective studies of REBOA and axillo-subclavian injuries were systematically reviewed.

Results

A total of 7 studies on REBOA and 10 studies on endovascular repair of axillo-subclavian injuries were included. Overall, REBOA was used as an adjunct for hemorrhage control and resuscitation in patients at risk of cardiopulmonary arrest, preventing further cardiovascular collapse successfully. For axillo-subclavian injuries, endovascular stent placement had efficacy comparable to the traditional open repair.

Conclusion

REBOA is a safe and effective alternative to open thoracotomy in critically ill trauma patients at risk of death due to torso hemorrhage. Endovascular repair outcomes are comparable to open repair after axillo-subclavian injuries. Long-term results of endovascular repair remain to be defined in this patient population.
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Metadata
Title
Endovascular solutions for the management of penetrating trauma: an update on REBOA and axillo-subclavian injuries
Authors
B. C. Branco
J. J. DuBose
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 6/2016
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-016-0739-5

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