Details

Autor(en) / Beteiligte

• Carrafiello, Gianpaolo, PhD
• Laganà, Domenico, MD
• Mangini, Monica, MD
• Fontana, Federico, MD
• Chiara, Recaldini, MD
• Filippo, Piacentino, MD
• Carlo, Pellegrino, MD
• Piffaretti, Gabriele, MD
• Fugazzola, Carlo, PhD

Titel

Percutaneous Treatment of Traumatic Upper-extremity Arterial Injuries: A Single-center Experience

Ist Teil von

• Journal of vascular and interventional radiology, 2011, Vol.22 (1), p.34-39

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2011

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose To assess the feasibility and effectiveness of emergency percutaneous treatment of traumatic injuries of upper-extremity arteries. Materials and Methods Between January 2000 and December 2007, 11 patients (mean age, 49.9 years) with traumatic injuries of upper-extremity arteries were observed: three had pseudoaneurysms, four had dissections, three had transections, and one had mural hematoma. Lesions involved the axillary ( n = 6), subclavian ( n = 3), or brachial artery ( n = 2). Pseudoaneurysms and transections were treated with stent grafts, ( n = 6) and dissections and mural hematomas were treated with bare stents ( n = 2) or angioplasty ( n = 3). Follow-up (mean, 45.1 months; range, 12–84 months) was performed with color Doppler ultrasonography at 1, 3, 6, and 12 months and then, yearly. Results Immediate technical success was obtained in all cases. No major complications occurred; there was one asymptomatic occlusion of the interosseous artery and one case of incomplete thrombosis of the radial artery (with recanalization after 1 month with systemic medical therapy). During a mean follow-up of 45.1 months, one stent-graft occlusion occurred, which was treated with intraarterial pharmacologic thrombolysis (urokinase 60,000 IU/h for 12 hours). Overall primary clinical success rate was 95.2% and secondary clinical success rate was 100%. Conclusions Percutaneous treatment is a feasible and safe tool for injuries of upper-extremity arteries because it can provide a fast and definitive termination of bleeding or a resolution of acute ischemia. This approach, with its low invasiveness, can be proposed as first-line treatment in patients with traumatic lesions of upper-extremity arteries.