Emergency endovascular repair for traumatic injury of the inferior vena cava.
Conventional open repair of the traumatic injuries of the inferior vena cava still represents a surgical challenge, since it carries high morbidity and mortality rates close to 100% in emergency setting. Surgical techniques required the total mobilization of the liver in the former case and the anatomic exposure of the aorto-iliac bifurcation in the latter. We report a case of uncontrolled hemorrhage from the inferior vena cava, managed by endovascular technique. A 65-year-old woman underwent endovascular stent-grafting for traumatic injury of the inferior vena cava. We performed the endovascular approach as we similarly did for aortic repair using a simple groin access through the common femoral vein; no additional dissection of the inferior vena cava or adjacent structures was needed using endovascular approach, thus avoiding additional operative trauma, and time with the stent-graft procedure was 9 min. Inferior vena cava stent-grafting without laparotomy and retroperitoneal dissection is feasible and could be a very attractive alternative to open surgery for rupture of the vena cava.
Castelli
Patrizio
P
Vascular Surgery-Department of Surgery, University of Insubria, Ospedale di Circolo, viale Borri 57, 21100 Varese, Italy.
Caronno
Roberto
R
Piffaretti
Gabriele
G
Tozzi
Matteo
M
D000368:Aged; D017546:Angioscopy / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D015607:Stents; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*