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https://www.readbyqxmd.com/read/28529680/-beyond-saving-lives-current-perspectives-of-interventional-radiology-in-trauma
#1
REVIEW
Anuradha Singh, Atin Kumar, Pawan Kumar, Subodh Kumar, Shivanand Gamanagatti
Interventional radiology (IR) has become an integral part in the management of traumatic injuries. There is an ever-increasing role of IR in traumatic injuries of solid abdominal organs, pelvic and peripheral arteries to control active bleeding by therapeutic embolization or vascular reconstruction using stent grafts. Traditionally, these endovascular treatments have been offered to hemodynamically stable patients. However, in recent times endovascular approach has become preferable to surgery even in hemodynamically unstable patients with injury of surgically difficult-to-access sites...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28499862/successful-revascularization-of-aortic-arch-in-a-39-year-old-blunt-trauma-patient-with-acute-diffuse-axonal-injury-without-the-use-of-systemic-anticoagulation
#2
Andrew M Abi-Chaker, Keith M Jones, Priscilla Sanchez, Jordan Sasson, Xiaoyi Li, Jorge Rey
BACKGROUND: Blunt traumatic aortic injury is the second leading cause of death in trauma patients age 4 to 34. Of the patients that are able to receive treatment, mortality rates as high as 40% have been reported. Endovascular repair options have allowed for more expeditious repairs with reduced iatrogenic trauma; however, when the injury involves the ascending aorta or arch, current endografts lack fenestrations needed for cerebral blood flow. Traditionally, on pump cardiopulmonary bypass with systemic anticoagulation has been used to repair these injuries...
May 9, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28485656/delayed-massive-epistaxis-from-traumatic-cavernous-carotid-false-aneurysms-a-report-of-two-unusual-cases
#3
Ncedile Mankahla, David LeFeuvre, Allan Taylor
Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28484831/a-case-of-refractory-subgaleal-hematoma-in-adolescence-treated-with-aspiration-and-endovascular-surgery
#4
Daisuke Wajima, Ichiro Nakagawa, Yukiko Kotani, Takeshi Wada, Hiroshi Yokota, Young-Soo Park, Kimihiko Kichikawa, Hiroyuki Nakase
A 14-year-old boy experienced sudden headache in the left parietal region, without any history of head trauma. Approximately 40 ml of hematoma was aspirated using a 22-gauge needle, and scalp swelling immediately disappeared. However, the swelling recurred bilaterally 2 weeks later. Left external carotid angiography revealed a reticular shadow consistent with subgaleal hematoma from a branch of bilateral superficial temporal arteries, without any arteriovenous shunts. The patient was successfully treated using the combination of hematoma aspiration and embolization of the superficial temporal artery...
May 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28480112/nontraumatic-posterior-circulation-pseudoaneurysm-of-the-basilar-artery-summit-with-complete-spontaneous-resolution-case-report-and-literature-review
#5
Nefize Turan, Shannon Butler, Theodore C Larson, Alexander Mason
BACKGROUND: Intracranial pseudoaneurysms are rare vascular defects of arterial walls that are classically the result of traumatic injury, iatrogenic causes, or infection. Idiopathic pseudoaneurysms are seen even less frequently and are often related to atherosclerosis. Pseudoaneurysms are most commonly found along the distal wall of the internal carotid artery, however, can occur at any location in the cerebrovascular circulation. Treatment of these arterial defects is often challenging due to their frail nature...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28475705/management-of-penetrating-cerebrovascular-injuries-in-pediatric-trauma-a-retrospective-multicenter-study
#6
Vijay M Ravindra, Michael C Dewan, Hassan Akbari, Robert J Bollo, David Limbrick, Andrew Jea, Robert P Naftel, Jay K Riva-Cambrin
BACKGROUND: Blunt cerebrovascular injury is uncommon in the pediatric population; penetrating cerebrovascular injuries are even rarer and are thus poorly understood. OBJECTIVE: To describe the diagnosis and management of penetrating cerebrovascular injuries and describe outcomes of available treatment modalities. METHODS: Clinical and radiographic data were collected retrospectively from a multicenter trauma registry for children screened for cerebrovascular injury during 2003 to 2013 at 4 academic pediatric trauma centers...
May 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28473356/a-case-of-pulsatile-scalp-swelling-in-a-child
#7
Daisy Khera, Pushpinder Singh Khera, Arvind Sinha, Neeraj Mehta
Arteriovenous fistulas (AVF) are an entity most commonly seen in the head and neck region. An AVF is a direct connection between the arterial feeders and the draining veins without intervening capillary beds (unlike an arteriovenous malformation in which a nidus intervenes between the arteries and veins). We describe a case of traumatic AVF in a child aged 9 years, who presented with a pulsatile scalp swelling following blunt trauma to the head. It turned out to be an AVF between the superficial temporal artery and vein...
May 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28471152/endovascular-treatment-of-traumatic-thoracic-aortic-lesions-a-systematic-review-and-meta-analysis
#8
Cornelis P van der Zee, Tryfon Vainas, Freek A van Brussel, Ignace F Tielliu, Clark J Zeebregts, Maarten J van der Laan
BACKGROUND: To provide an overview of the experience of endovascular treatment for traumatic thoracic aortic lesions (TTAL). Thoracic aortic injury secondary to high-energy chest trauma constitutes an emergency situation with potentially devastating outcome. In the present time, the majority of patients are treated with thoracic endovascular aortic repair. The aim of this study was to provide a systematic overview of endovascular aortic repair in patients with TTAL with special attention to perioperative mortality, paraplegia, stroke, influence of left subclavian artery (LSA) coverage herein, and long term stent related complications...
May 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28452887/multicenter-retrospective-study-of-non-compressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#9
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
OBJECTIVE: Rational development of technology for rapid control of non-compressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) versus open (OPEN) management. METHODS: Retrospective study of adult trauma patients with NCTH admitted to 4 urban level 1 trauma centers in the Houston and San Antonio metropolitan areas in 2008-2012...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452616/an-ovine-model-of-cerebral-catheter-venography-for-implantation-of-an-endovascular-neural-interface
#10
Thomas James Oxley, Nicholas Lachlan Opie, Gil Simon Rind, Kishan Liyanage, Sam Emmanuel John, Stephen Ronayne, Alan James McDonald, Anthony Dornom, Timothy John Haynes Lovell, Peter John Mitchell, Iwan Bennett, Sebastien Bauquier, Leon Norris Warne, Chris Steward, David Bruce Grayden, Patricia Desmond, Stephen M Davis, Terence John O'Brien, Clive N May
OBJECTIVE Neural interface technology may enable the development of novel therapies to treat neurological conditions, including motor prostheses for spinal cord injury. Intracranial neural interfaces currently require a craniotomy to achieve implantation and may result in chronic tissue inflammation. Novel approaches are required that achieve less invasive implantation methods while maintaining high spatial resolution. An endovascular stent electrode array avoids direct brain trauma and is able to record electrocorticography in local cortical tissue from within the venous vasculature...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28451716/-interventional-radiology-in-the-head-and-neck-region
#11
C Mayer, E Hattingen, H Schild, F Bootz, A Schröck
In interventional neuroradiology, endovascular embolization represents an important and helpful tool in the treatment of multiple head and neck diseases. These interventional procedures may be performed with curative intent, to reduce the surgical risk within a multimodal treatment concept, or to improve or at least maintain a good quality of life within a palliative therapy concept. In addition to a good understanding of disease pathology, knowledge of vascular anatomy, including collateral vessels and dangerous extracranial-intracranial anastomoses, is essential for successful treatment, as is implementation of an established technique using appropriate material...
April 27, 2017: HNO
https://www.readbyqxmd.com/read/28448605/vasopressor-use-following-traumatic-injury-a-single-center-retrospective-study
#12
Mathieu Hylands, Marie-Pier Godbout, Sandeep K Mayer, William D Fraser, Alain Vanasse, Marc-André Leclair, Alexis F Turgeon, François Lauzier, Emmanuel Charbonney, Vincent Trottier, Tarek S Razek, André Roy, Frédérick D'Aragon, Emilie Belley-Côté, Andrew G Day, Soazig Le Guillan, Robert Sabbagh, François Lamontagne
OBJECTIVES: Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. METHODS: We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included...
2017: PloS One
https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#13
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#14
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422912/vascular-complications-from-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-life-over-limb
#15
John R Taylor, John A Harvin, Clay Martin, John B Holcomb, Laura J Moore
BACKGROUND: Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA) have been reported as high as 13% with some patients requiring lower extremity amputation. We sought to review our institutions series of REBOA and assess our vascular complications. METHODS: Retrospective review of all patients undergoing REBOA from October 2011 through July 2016. Data was gathered from the Memorial Hermann Trauma registry and the hospital electronic medical records...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#16
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28395494/-diagnosis-and-treatment-of-traumatic-optic-neuropathy-with-internal-carotid-artery-trauma
#17
Q J Fan, L Y Ni, X J Liu, Y Zeng, L F Jiang, B Zheng
Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness...
March 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28392101/surgical-and-endovascular-treatments-of-extracranial-carotid-artery-aneurysms-report-of-six-cases
#18
Shusuke Yamamoto, Naoki Akioka, Daina Kashiwazaki, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
BACKGROUND: Although the natural course of extracranial carotid artery aneurysms (ECAAs) is still unknown, they may cause stroke or cranial nerve dysfunction unless they are treated. In this report, we reviewed the clinical results of 6 patients who underwent endovascular and surgical treatments for ECAAs. METHODS: A total of 6 patients underwent endovascular and surgical treatments for ECAAs for 9 years. The primary causes of ECAAs included Marfan syndrome (1 patient), infection (1 patient), trauma (2 patients), and unknown (2 patients)...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28390919/symptomatic-deep-femoral-artery-pseudoaneurysm-endovascular-exclusion-case-report-and-literature-review
#19
Felice Pecoraro, Ettore Dinoto, Umberto M Bracale, Giovanni Badalamenti, Arduino Farina, Guido Bajardi
Deep femoral artery pseusoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.9 cm). The patient was managed urgently, under local anaesthesia, by placement in the distal DFA of a Viabahn 8 x 100mm stent-graft (W L Gore & Associates, Inc). The post-operative course was uneventful and the 24-months CT showed regular stent-graft patency and 20 mm DFPA shrinkage...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#20
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
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