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| Jian-Long Liu,Jin-Yong Li,Peng Jiang,Wei Jia,Xuan Tian,Zhi-Yuan Cheng,Yun-Xin Zhang.[J].Chin J Traumatol,2020,23(1):5-9. [doi] |
| Literature review of peripheral vascular trauma: Is the era of intervention coming? |
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| DOI： |
| KeyWord: Endovascular proceduresSurgical proceduresOperativePeripheral vascular trauma |
| FundProject: |
| Author Name | Affiliation | | Jian-Long Liu | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China | | Jin-Yong Li | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100036, China | | Peng Jiang | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100037, China | | Wei Jia | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100038, China | | Xuan Tian | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100039, China | | Zhi-Yuan Cheng | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100040, China | | Yun-Xin Zhang | Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100041, China |
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| Abstract: |
| Traumatic peripheral vascular injury is a significant cause of disability and death either in civilian environments or on the battlefield. Penetrating trauma and blunt trauma are the most common forms of vascular injuries. Besides, iatrogenic arterial injury (IAI) is another pattern of vascular trauma. The management of peripheral vascular injuries has been improved in different environments and wars. There are different types of vascular injuries, such as vasospasm, contusion, intimal flaps, intimal disruption or hematoma, external compression, laceration, transection and focal wall defects, etc. The main clinical manifestations of vascular injuries are shock following massive hemorrhage and limb
necrosis due to tissue and organ ischemia. Ultrasound, computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are most valuable for assessment of peripheral vascular injuries. Angiography remains the gold standard for diagnosing vascular trauma. Immediate hemorrhage control and rapid restoration of blood flow are the primary goals of vascular trauma treatment. There are many operative treatment methods for vascular injuries, such as vascular suture or ligation, vascular wall repair and vascular reconstruction with blood vessel prostheses or vascular grafts. Embolization, balloon dilation and covered stent implantation are the main endovascular techniques. Surgical operation is still
the primary treatment for vascular injuries. Endovascular treatment is a promising alternative, proved to be safe and effective, and preferred selection for patients. In summary, rapid diagnosis and timely surgical intervention remain the mainstays of the treatment. However, many issues need to be resolved by further studies. |
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