Endovascular surgery as a bridge solution for selected vascular emergencies.
Vascular emergencies patients present with several problems requiring immediate sufficient evaluation of the situation and intervention in order to save life, limb, or a serious health injury. Endovascular surgery may be very useful as bridging technique in order to obtain immediate bleeding control. Additionally, a remarkable number of patients has poor general health conditions and is unfit for open repair. The surgical solution would be invasive and prohibitive for this high-risk patient's subgroup. Endovascular techniques play an important role in the management of vascular emergencies. They allow treatment to be rapidly coupled with diagnosis, especially beneficial parameter for traumatic injuries. In particular, embolization is a well-established technique for hemostasis and is preferable when intervention for bleeding pelvic fractures is necessary. Additionally, in case of significant tissue destruction and contamination in the vicinity of the injury vascular access by endovascular techniques may be advantageous. Finally, endovascular balloon occlusion for vascular control may be used as an adjunct to surgery when conventional exposure is technically challenging and hazardous. The objectives of this review article are to highlight the utility of endovascular surgery in vascular emergencies and to compare current treatment options of urgent clinical entities, based on the literature.
Donas
K P
KP
Department of Vascular Surgery, St. Franziskus Hospital Münster, Münster, Germany. k.donas@gmx.at
Torsello
G F
GF
D004636:Emergency Service, Hospital; D004638:Emergency Treatment; D019317:Evidence-Based Medicine; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D014656:Vascular Surgical Procedures