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.	馬丹, 劉敏, 楊樺, 等. 損傷控制性手術策略在地震創傷急救中的應用. 創傷外科雜志, 2008, 10(5): 400-401, 406.
2.	王大東, 焦華波, 譚向龍, 等. 介入治療在伴危重癥腹部疾病損傷控制性手術中的應用. 肝膽胰外科雜志, 2009, 21(6): 450-453.
3.	詹世林, 陳建雄, 彭林輝, 等. 血管介入技術在嚴重肝外傷損傷控制中的應用. 嶺南現代臨床外科, 2012, 12(1): 26-27, 31.
4.	劉剛, 唐詩添, 王軍, 等. 血管腔內治療隱匿性動脈損傷的臨床效果. 中華骨科雜志, 2016, 36(6): 336-343.
5.	段鵬飛, 李曉強, 吳浩榮, 等. 外傷性血管損傷的手術及介入治療. 中華創傷雜志, 2008, 24(11): 936-938.
6.	戴貽權, 陳宏宇, 郭平凡. 外周血管創傷的腔內治療經驗. 血管與腔內血管外科雜志, 2015, 1(Z1): 108-112.
7.	李春孟. 腔內介入技術治療下肢血管損傷的安全性及有效性評估. 浙江: 浙江大學, 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.	成軍, 趙渝, 張矛, 等. 覆膜支架在周圍動脈血管損傷救治中的應用. 中國血管外科雜志: 電子版, 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.	楊志, 杜華, 劉暢, 等. 急診介入栓塞治療腎臟創傷性出血. 中國微創外科雜志, 2015, 15(9): 815-817, 821.
19.	金桂云, 史鍵山, 鄧堂, 等. 急診介入動脈栓塞術聯合經皮微創螺釘內固定術救治骨盆骨折合并失血性休克(附21例分析). 中國介入影像與治療學, 2017, 14(10): 587-591.
20.	張希全, 葛世堂, 陳眾, 等. 腔內修復術對外周血管創傷患者的中遠期療效分析. 第三軍醫大學學報, 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.	宋慶宏, 李陽春, 趙奇, 等. VIABAHN支架治療下肢動脈閉塞的效果分析. 天津醫藥, 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. 馬丹, 劉敏, 楊樺, 等. 損傷控制性手術策略在地震創傷急救中的應用. 創傷外科雜志, 2008, 10(5): 400-401, 406.
2. 王大東, 焦華波, 譚向龍, 等. 介入治療在伴危重癥腹部疾病損傷控制性手術中的應用. 肝膽胰外科雜志, 2009, 21(6): 450-453.
3. 詹世林, 陳建雄, 彭林輝, 等. 血管介入技術在嚴重肝外傷損傷控制中的應用. 嶺南現代臨床外科, 2012, 12(1): 26-27, 31.
4. 劉剛, 唐詩添, 王軍, 等. 血管腔內治療隱匿性動脈損傷的臨床效果. 中華骨科雜志, 2016, 36(6): 336-343.
5. 段鵬飛, 李曉強, 吳浩榮, 等. 外傷性血管損傷的手術及介入治療. 中華創傷雜志, 2008, 24(11): 936-938.
6. 戴貽權, 陳宏宇, 郭平凡. 外周血管創傷的腔內治療經驗. 血管與腔內血管外科雜志, 2015, 1(Z1): 108-112.
7. 李春孟. 腔內介入技術治療下肢血管損傷的安全性及有效性評估. 浙江: 浙江大學, 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. 成軍, 趙渝, 張矛, 等. 覆膜支架在周圍動脈血管損傷救治中的應用. 中國血管外科雜志: 電子版, 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. 楊志, 杜華, 劉暢, 等. 急診介入栓塞治療腎臟創傷性出血. 中國微創外科雜志, 2015, 15(9): 815-817, 821.
19. 金桂云, 史鍵山, 鄧堂, 等. 急診介入動脈栓塞術聯合經皮微創螺釘內固定術救治骨盆骨折合并失血性休克(附21例分析). 中國介入影像與治療學, 2017, 14(10): 587-591.
20. 張希全, 葛世堂, 陳眾, 等. 腔內修復術對外周血管創傷患者的中遠期療效分析. 第三軍醫大學學報, 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. 宋慶宏, 李陽春, 趙奇, 等. VIABAHN支架治療下肢動脈閉塞的效果分析. 天津醫藥, 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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