Endovascular repair of blunt extremity arterial injury: case report.
OBJECTIVE
Surgical revascularization is the standard treatment of complex blunt traumatic extremity vascular injuries. Limb salvage may be improved with minimally invasive endovascular therapies because of the ability to perform diagnostic and therapeutic intervention simultaneously. Two cases of acute limb-threatening arterial injuries successfully treated with percutaneous endovascular therapy are reported.


RESULTS
A skier suffered hemodynamic instability after shoulder reduction. An axillary arterial injury was suspected and confirmed with angiography. A covered stent successfully controlled the hemorrhage. A morbidly obese female sustained anterior dislocation of her left knee 7 years previously requiring repair. She developed recurrent knee dislocation with acute leg ischemia. Emergent fixation was performed followed by percutaneous angiography. Short segment thrombosis of the popliteal was noted. Wire recanalization of the thrombosed artery and stent placement restored 3-vessel runoff.


CONCLUSIONS
Endovascular therapy can offer faster, easier access to the extremity vascular injury facilitating revascularization and avoiding long incisions and dissections.
Zimmerman
Pamela
P
Division of Vascular and Endovascular Surgery, Department of Surgery, West Virginia University Medical Center, Morgantown, West Virginia, USA. pzimmerman@hsc.wvu.edu
d'Audiffret
Alexandre
A
Pillai
Lakshmikumar
L
D000328:Adult; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D001158:Arteries / Q000293:injuries; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000628:therapy; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D031221:Knee Dislocation / Q000601:surgery; D008297:Male; D008349:Manipulation, Orthopedic / Q000009:adverse effects*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011859:Radiography; D012783:Shoulder Dislocation / Q000628:therapy; D012865:Skiing; D015607:Stents; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*