Introduction Penetrating injuries to the heart and great vessels result in significant prehospital mortality (50% to 75% for cardiac wounds), so the numbers of patients undergoing operations for such injuries are small even in the busiest civilian centers or wartime…
Why This Chapter? Vascular and endovascular trauma management is a rapidly developing field, which is dominated by medical devices. The preceding chapters in this section have highlighted key developments, such as stentgrafts, coils, plugs, resuscitative endovascular balloon occlusion of the…
Introduction Mechanical trauma to major arteries often leads to significant vascular compromise to large tissue beds which then results in the reduction in oxygen delivery, cellular dysoxia, and cell death. This occurs in varying degrees, depending on the robustness of…
Introduction Selective aortic arch perfusion (SAAP) is an emerging endovascular resuscitation technique that provides temporary extracorporeal perfusion to the heart and brain during cardiac arrest. The aim of SAAP is to reverse the cardiac arrest, resulting in restoration of intrinsic…
Introduction Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly utilized for patients with exsanguinating truncal hemorrhage. This treatment has proven effective at rapidly restoring perfusion to the heart and brain, while simultaneously minimizing hemorrhage below the level of…
Introduction Uncontrolled hemorrhage is the leading cause of preventable death in both the civilian and military settings. Thus, to achieve zero preventable deaths following trauma, prompt and effective control of noncompressible torso hemorrhage is essential. This may require aortic occlusion…
Introduction Hemorrhage is the leading cause of preventable death in trauma patients, with 96% of those patients dying from noncompressible torso or junctional hemorrhage. As endovascular techniques have become more ubiquitous for elective and emergent vascular cases, there has been…
Introduction Hemorrhage control is a critical component of any facility that manages trauma patients. This core capability exists in many forms, from mechanical devices, such as tourniquets for extremity hemorrhage to invasive surgical procedures. Within the domain of hospital care,…
Background The evolution of imaging for the diagnosis and treatment of vascular injury has evolved with the development of imaging technologies, increased availability of advanced modalities, and changing treatment paradigms. Diagnostic arteriography was first used in 1927 by Egas Moniz,…
Introduction Vascular trauma presents in a variety of settings and results in findings that range from life-threatening hemorrhage secondary to major torso or extremity vessel disruption to no detectable signs in occult injuries. Effective management is based upon early diagnosis…