Application of vascular interventional technique in arterial injuries of damage control surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANG Xiquan ¹ , GE Shitang ¹ , ZHANG Yan ² , WANG Ying ³ , CHEN Zhong ¹ , DOU Shubin ¹

1. Interventional Endovascular Treatment Center, No. 960 Hospital of Chinese People’s Liberation Army, Zibo, Shandong 255300, P. R. China;
2. Department of Radiology, No. 960 Hospital of Chinese People’s Liberation Army, Jinan 250031, P. R. China;
3. Department of Nursing, No. 960 Hospital of Chinese People’s Liberation Army, Zibo, Shandong 255300, P. R. China;

Corresponding author：

ZHANG Xiquan, Email: jrkzxq@163.com

Keywords：

arterial injury; endovascular therapy; damage control; clinical application

DOI：

10.7507/1007-9424.201810036

Video：

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Objective To investigate the effect of vascular interventional technique in arterial injuries of damage control surgery.Methods A retrospective review was made on clinical data of 31 arterial injuries cases who received damage control surgery from March 2011 to June 2018. All cases underwent endovascular therapy for arterial injuries in No. 960 Hospital of Chinese People’s Liberation Army, and then the definitive operation was operated as soon as the vital signs became stable.Results The surgery was successful in all patients, and the operation time was 43–100 min (average of 57 min), the intraoperative blood loss was 50–200 mL (average of 80 mL). Bleeding was successful controlled in 11 cases with covered stents, 9 cases with multiple overlapping bare stents, and 11 cases with spring coil, all cases with shock were improved immediately. There were no perioperative mortality or procedure-related complication occurred. All cases were discharged from hospital smoothly after two-phase surgery. All the patients were followed up for 6 to 24 months [(17±5) months]. Two patients with covered stent lumen stenosis less than 50% as showed by angiography, and no secondary treatment was required. In addition, blood flow patency was kept in the rest of artery, no bleeding occurred in injured artery. During the follow-up period, the collateral vessels of 9 patients treated with multi-layerbare stent overlapping technique were unobstructed. Stent migration, fracture or leakage was not found during the follow-up period. Patients recovered well after definitive surgery, they had good fracture healing with a disability rate of 0.Conclusion Rational application of vascular interventional technique in damage control surgery is a safe and effective treatment method for arterial injuries combined with other traumas.

Citation： ZHANG Xiquan, GE Shitang, ZHANG Yan, WANG Ying, CHEN Zhong, DOU Shubin. Application of vascular interventional technique in arterial injuries of damage control surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(2): 148-152. doi: 10.7507/1007-9424.201810036 Copy

1.	马丹, 刘敏, 杨桦, 等. 损伤控制性手术策略在地震创伤急救中的应用. 创伤外科杂志, 2008, 10(5): 400-401, 406.
2.	王大东, 焦华波, 谭向龙, 等. 介入治疗在伴危重症腹部疾病损伤控制性手术中的应用. 肝胆胰外科杂志, 2009, 21(6): 450-453.
3.	詹世林, 陈建雄, 彭林辉, 等. 血管介入技术在严重肝外伤损伤控制中的应用. 岭南现代临床外科, 2012, 12(1): 26-27, 31.
4.	刘刚, 唐诗添, 王军, 等. 血管腔内治疗隐匿性动脉损伤的临床效果. 中华骨科杂志, 2016, 36(6): 336-343.
5.	段鹏飞, 李晓强, 吴浩荣, 等. 外伤性血管损伤的手术及介入治疗. 中华创伤杂志, 2008, 24(11): 936-938.
6.	戴贻权, 陈宏宇, 郭平凡. 外周血管创伤的腔内治疗经验. 血管与腔内血管外科杂志, 2015, 1(Z1): 108-112.
7.	李春孟. 腔内介入技术治疗下肢血管损伤的安全性及有效性评估. 浙江: 浙江大学, 2017.
8.	Worni M, Scarborough JE, Gandhi M, et al. Use of endovascular therapy for peripheral arterial lesions: an analysis of the National Trauma Data Bank from 2007 to 2009. Ann Vasc Surg, 2013, 27(3): 299-305.
9.	Rotondo MF, Schwab CW, McGonigal MD, et al. ‘Damage control’: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma, 1993, 35(3): 375-382.
10.	Krausz AA, Krausz MM, Picetti E. Maxillofacial and neck trauma: a damage control approach. World J Emerg Surg, 2015, 10(1): 31-39.
11.	Sharrock AE, Midwinter M. Damage control-trauma care in the first hour and beyond: a clinical review of relevant developments in the field of trauma care. Ann R Coll Surg Engl, 2013, 95(3): 177-183.
12.	Tong DC, Breeze J. Damage control surgery and combat-related maxillofacial and cervical injuries: a systematic review. Br J Oral Maxillofac Surg, 2016, 54(1): 8-12.
13.	Nicola R. Early total care versus damage control: current concepts in the orthopedic care of polytrauma patients. ISRN Orthop, 2013, 2013: 329452.
14.	成军, 赵渝, 张矛, 等. 覆膜支架在周围动脉血管损伤救治中的应用. 中国血管外科杂志: 电子版, 2012, 4(1): 31-34.
15.	Zhong S, Zhang X, Chen Z, et al. Endovascular repair of blunt popliteal arterial injuries. Korean J Radiol, 2016, 17(5): 789-796.
16.	Shalhub S, Starnes BW, Tran NT. Endovascular treatment of axillosubclavian arterial transection in patients with blunt traumatic injury. J Vasc Surg, 2011, 53(4): 1141-1144.
17.	Rohlffs F, Larena-Avellaneda AA, Petersen JP, et al. Through-and-through wire technique for endovascular damage control in traumatic proximal axillary artery transection. Vascular, 2015, 23(1): 99-101.
18.	杨志, 杜华, 刘畅, 等. 急诊介入栓塞治疗肾脏创伤性出血. 中国微创外科杂志, 2015, 15(9): 815-817, 821.
19.	金桂云, 史键山, 邓堂, 等. 急诊介入动脉栓塞术联合经皮微创螺钉内固定术救治骨盆骨折合并失血性休克(附21例分析). 中国介入影像与治疗学, 2017, 14(10): 587-591.
20.	张希全, 葛世堂, 陈众, 等. 腔内修复术对外周血管创伤患者的中远期疗效分析. 第三军医大学学报, 2017, 39(20): 1998-2003.
21.	Ruffino MA, Rabbia C; Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the Cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J Endovasc Ther, 2012, 19(5): 599-610.
22.	Adlakha S, Sheikh M, Wu J, et al. Stent fracture in the coronary and peripheral arteries. J Interv Cardiol, 2010, 23(4): 411-419.
23.	Nikanorov A, Smouse HB, Osman K, et al. Fracture of self-expanding nitinol stents stressed in vitro under simulated intravascular conditions. J Vasc Surg, 2008, 48(2): 435-440.
24.	宋庆宏, 李阳春, 赵奇, 等. VIABAHN支架治疗下肢动脉闭塞的效果分析. 天津医药, 2014, 42(8): 825-826, 827.
25.	Doomernik DE, Golchehr B, Lensvelt MM, et al. The role of superficial femoral artery endoluminal bypass in long de novo lesions and in-stent restenosis. J Cardiovasc Surg (Torino), 2012, 53(4): 447-457.

1. 马丹, 刘敏, 杨桦, 等. 损伤控制性手术策略在地震创伤急救中的应用. 创伤外科杂志, 2008, 10(5): 400-401, 406.
2. 王大东, 焦华波, 谭向龙, 等. 介入治疗在伴危重症腹部疾病损伤控制性手术中的应用. 肝胆胰外科杂志, 2009, 21(6): 450-453.
3. 詹世林, 陈建雄, 彭林辉, 等. 血管介入技术在严重肝外伤损伤控制中的应用. 岭南现代临床外科, 2012, 12(1): 26-27, 31.
4. 刘刚, 唐诗添, 王军, 等. 血管腔内治疗隐匿性动脉损伤的临床效果. 中华骨科杂志, 2016, 36(6): 336-343.
5. 段鹏飞, 李晓强, 吴浩荣, 等. 外伤性血管损伤的手术及介入治疗. 中华创伤杂志, 2008, 24(11): 936-938.
6. 戴贻权, 陈宏宇, 郭平凡. 外周血管创伤的腔内治疗经验. 血管与腔内血管外科杂志, 2015, 1(Z1): 108-112.
7. 李春孟. 腔内介入技术治疗下肢血管损伤的安全性及有效性评估. 浙江: 浙江大学, 2017.
8. Worni M, Scarborough JE, Gandhi M, et al. Use of endovascular therapy for peripheral arterial lesions: an analysis of the National Trauma Data Bank from 2007 to 2009. Ann Vasc Surg, 2013, 27(3): 299-305.
9. Rotondo MF, Schwab CW, McGonigal MD, et al. ‘Damage control’: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma, 1993, 35(3): 375-382.
10. Krausz AA, Krausz MM, Picetti E. Maxillofacial and neck trauma: a damage control approach. World J Emerg Surg, 2015, 10(1): 31-39.
11. Sharrock AE, Midwinter M. Damage control-trauma care in the first hour and beyond: a clinical review of relevant developments in the field of trauma care. Ann R Coll Surg Engl, 2013, 95(3): 177-183.
12. Tong DC, Breeze J. Damage control surgery and combat-related maxillofacial and cervical injuries: a systematic review. Br J Oral Maxillofac Surg, 2016, 54(1): 8-12.
13. Nicola R. Early total care versus damage control: current concepts in the orthopedic care of polytrauma patients. ISRN Orthop, 2013, 2013: 329452.
14. 成军, 赵渝, 张矛, 等. 覆膜支架在周围动脉血管损伤救治中的应用. 中国血管外科杂志: 电子版, 2012, 4(1): 31-34.
15. Zhong S, Zhang X, Chen Z, et al. Endovascular repair of blunt popliteal arterial injuries. Korean J Radiol, 2016, 17(5): 789-796.
16. Shalhub S, Starnes BW, Tran NT. Endovascular treatment of axillosubclavian arterial transection in patients with blunt traumatic injury. J Vasc Surg, 2011, 53(4): 1141-1144.
17. Rohlffs F, Larena-Avellaneda AA, Petersen JP, et al. Through-and-through wire technique for endovascular damage control in traumatic proximal axillary artery transection. Vascular, 2015, 23(1): 99-101.
18. 杨志, 杜华, 刘畅, 等. 急诊介入栓塞治疗肾脏创伤性出血. 中国微创外科杂志, 2015, 15(9): 815-817, 821.
19. 金桂云, 史键山, 邓堂, 等. 急诊介入动脉栓塞术联合经皮微创螺钉内固定术救治骨盆骨折合并失血性休克(附21例分析). 中国介入影像与治疗学, 2017, 14(10): 587-591.
20. 张希全, 葛世堂, 陈众, 等. 腔内修复术对外周血管创伤患者的中远期疗效分析. 第三军医大学学报, 2017, 39(20): 1998-2003.
21. Ruffino MA, Rabbia C; Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the Cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J Endovasc Ther, 2012, 19(5): 599-610.
22. Adlakha S, Sheikh M, Wu J, et al. Stent fracture in the coronary and peripheral arteries. J Interv Cardiol, 2010, 23(4): 411-419.
23. Nikanorov A, Smouse HB, Osman K, et al. Fracture of self-expanding nitinol stents stressed in vitro under simulated intravascular conditions. J Vasc Surg, 2008, 48(2): 435-440.
24. 宋庆宏, 李阳春, 赵奇, 等. VIABAHN支架治疗下肢动脉闭塞的效果分析. 天津医药, 2014, 42(8): 825-826, 827.
25. Doomernik DE, Golchehr B, Lensvelt MM, et al. The role of superficial femoral artery endoluminal bypass in long de novo lesions and in-stent restenosis. J Cardiovasc Surg (Torino), 2012, 53(4): 447-457.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of vascular interventional technique in arterial injuries of damage control surgery

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