RESUMO
Axillosubclavian artery injury is relatively uncommon; however, it is related to a high rate of morbidity and mortality. Although open repair as well as endovascular techniques have been proposed for the treatment of axillosubclavian artery injury, the ideal approach is still under investigation. We present a case of a 20-year-old patient who suffered from complete subclavian artery transection, following blunt thoracic trauma. Using percutaneous access, a balloon catheter was inflated under fluoroscopy, in the origin of his affected subclavian artery ceasing the haemorrhage, thus immediately afterwards he was submitted to arterial bypass. The combination of endovascular and open repair ensured his life and limb salvage while the complications of an otherwise extensive dissection were obviated.
RESUMO
This document presents the consensus recommendations of the Hellenic Stroke Organization which can be of assistance to the treating stroke physicians.
Assuntos
Isquemia Encefálica/terapia , Acidente Vascular Cerebral/terapia , Trombectomia/métodos , Humanos , Resultado do TratamentoRESUMO
Abdominopelvic trauma (APT) remains a leading cause of morbidity and mortality in the 15- to 44-year-old age group in the Western World. It can be life-threatening as abdominopelvic organs, specifically those in the retroperitoneal space, can bleed profusely. APT is divided into blunt and penetrating types. While surgery is notably considered as a definitive solution for bleeding control, it is not always the optimum treatment for the stabilization of a polytrauma patient. Over the past decades, there has been a shift toward more sophisticated strategies, such as non-operative management of abdominopelvic vascular trauma for haemodynamically stable patients. Angiographic embolization for bleeding control following blunt and/or penetrating intra- and retroperitoneal injuries has proven to be safe and effective. Embolization can achieve hemostasis and salvage organs without the morbidity of surgery, and the development and refinement of embolization techniques has widened the indications for non-operative treatment in solid organ injury. Moreover, advances in computed tomography provided more efficient scanning times with improved image quality. While surgery is still usually recommended for patients with penetrating injuries, non-operative management can be effectively used as well as an alternative treatment. We review indications, technical considerations, efficacy, and complication rates of angiographic embolization in APT.