Journal of EndoVascular Resuscitation and Trauma Management最新文献

{"title":"Open Balloon Tamponade and Hepatic Angiography for Hemorrhage Control of Transhepatic Gunshot Wounds in a Hybrid Trauma Operating Room Environment","authors":"M. Harfouche, J. Morrison, Rishi Kundi, J. Dubose, T. Scalea","doi":"10.26676/jevtm.v40i(2).131","DOIUrl":"https://doi.org/10.26676/jevtm.v40i(2).131","url":null,"abstract":"The management of high-grade liver trauma is challenging and mortality rates are high. Balloon tamponade is a valuable tool for control of transhepatic penetrating injuries. We report three cases of hybrid management of penetrating liver trauma with balloon tamponade and hepatic angiography in a hybrid operating room environment. The combination of balloon tamponade with hepatic angioembolization provides an enhanced approach for the management of these injuries. ","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46100085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Chimney Procedure: A Novel Technical Solution to Prevent Iatrogenic Budd– Chiari Syndrome Following Retrohepatic Vena Cava Injury","authors":"E. Heldenberg, D. Hebron, B. Kessel, O. Galili, I. Zoarets, Y. Klein, Aiya Assif","doi":"10.26676/jevtm.v40i(2).132","DOIUrl":"https://doi.org/10.26676/jevtm.v40i(2).132","url":null,"abstract":"Traumatic inferior vena cava (IVC) lesions account for approximately 25% of abdominal vascular injuries and are among the most challenging and lethal lesions sustained by trauma patients. Whether caused by blunt or penetrating mechanisms of injury, the overall mortality rate is up to 92%; as many as 50% of  the patients with those injuries die before reaching medical care, and the mortality rate among patients who arrive to a trauma center, with signs of life and/or receive operative treatment, ranges between 20% and 57% (1). \u0000Retrohepatic Vena Cava (RHVC) injuries (RHVCI) are extremely rare and as such both the treating trauma surgeon, as well as the vascular surgeon, lacks the necessary experience to deal with such complicated injuries. The mortality rates secondary to these injuries are extremely high, even with damage control management concepts application. Improving the outcome of these injuries remains a significant challenge of modern trauma care (2, 3). \u0000The treatment of RHVCI confronts the treating surgeon, with major obstacles, which raises from the anatomic location of the RHVC at the posterior aspect of the liver and the abundancy of bridging veins between the RHVC and the liver. These anatomic obstacles creates a major technical challenge of gaining proximal and distal control, in proximity to the injured RHVC. This many times necessitates abdominal as well as thoracic exposure in order to gain proper control. \u0000The average trauma, as well as the vascular, surgeons are not familiar with handling such complex injuries. This is even truer as referred to the new generation of vascular surgeons, whose experience with open vascular surgery, mainly in such extreme situations, decreases with the increasing usage of endovascular techniques (4).    \u0000 The advancements in endovascular techniques have introduced new alternatives to traditional open repair strategies. In many cases, RHVCI treatment requires exploration of a retro-hepatic hematoma, which might be the single thing that prevents free venous rupture and as such, it should be avoided.  Venous balloon occlusion is a novel endovascular strategy that may be particularly advantageous in those circumstances as a bridging maneuver, for proximal and distal control, during hybrid repair. Our case in unique since it highlights the option of total endovascular treatment, using arterial treatment concepts, to treat this extremely challenging injury.   \u0000 ","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48301302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Versus Open: Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta or Thoracotomy for Management of Post-Injury Noncompressible Torso Hemorrhage","authors":"D. Roberts, B. Cotton, J. Duchesne, P. Ferrada, T. Hörer, D. Kauvar, M. Khan, A. Kirkpatrick, C. Ordoñez, B. Perreira, Artai Priouzram, M. Brenner","doi":"10.26676/jevtm.v40i(2).136","DOIUrl":"https://doi.org/10.26676/jevtm.v40i(2).136","url":null,"abstract":"Non-compressible torso haemorrhage (NCTH) (i.e., bleeding from anatomical locations not amenable to control by direct pressure or tourniquet application) is a leading cause of potentially preventable death after injury. In select trauma patients with infra-diaphragmatic NCTH-related hemorrhagic shock or traumatic circulatory arrest, occlusion of the aorta proximal to the site of hemorrhage may sustain or restore spontaneous circulation. While the traditional method of achieving proximal aortic occlusion included Emergency Department thoracotomy (EDT) with descending thoracic aortic cross-clamping, resuscitative endovascular balloon occlusion of the aorta (REBOA) affords a less invasive option when thoracotomy is not required for other indications. In this manuscript, we review the innovation, pathophysiologic effects, indications for, and technique of EDT and partial, intermittent, and complete REBOA in injured patients, including recommended methods for reversing aortic occlusion. We also discuss advantages and disadvantages of each of these methods of proximal aortic occlusion and review studies comparing their effectiveness and safety for managing post-injury NCTH. We conclude the above by providing recommendations as to when each of these methods may be best when indicated to manage injured patients with NCTH.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44987474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest","authors":"J. Daley, K. Cannon, R. Buckley, A. Aydin, I. Latich, J. Lozada, J. Bonz, D. Joseph, R. Coughlin, J. Belsky, J. Sather, C. Wira, Rachel B. Liu, Austin Johnson, C. Moore","doi":"10.26676/jevtm.v40i(2).140","DOIUrl":"https://doi.org/10.26676/jevtm.v40i(2).140","url":null,"abstract":"Background \u0000There are over 395,000 out-of-hospital cardiac arrests (OHCA) annually in the United States with an estimated 70-90% mortality rate and fewer than 10% surviving with a favorable neurologic outcome. Research in animal models and early human studies suggests that REBOA may play a role in augmenting coronary perfusion during OHCA by reducing blood flow to the lower body and re-directing it towards the heart and brain. We describe our initial case and research protocol to investigate the feasibility of REBOA in the emergency department (ED) for OHCA as an adjunct to ACLS. \u0000Methods \u0000We plan to enroll twenty patients in a single-arm interventional device study utilizing an exception from informed consent over a two-year period. The primary outcome is feasibility, with secondary outcomes assessing for hemodynamic changes pre- and post-aortic occlusion. \u0000Results \u0000Enrollment began in January 2020 and is ongoing. For the initial patient, an EP obtained ultrasound guided common femoral arterial access under chest compressions, followed by advancement of the REBOA catheter by an interventional radiologist. Immediately after aortic occlusion, investigators noted a substantial improvement in mean arterial pressure (MAP) (37 mmHg to 50 mmHg) and end tidal carbon dioxide (ETCO2) (33 mmHg to 50 mmHg), with transient but non-sustained return of spontaneous circulation (ROSC). \u0000Conclusion \u0000This is the first research protocol and case report of ED-REBOA initiation involving emergency physicians (EP) for non-traumatic OHCA. We describe our research protocol and initial case of a patient in OHCA who and underwent successful REBOA placement in the ED as an adjunct to ACLS.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42278426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Custom Extracorporeal Circuit for Endovascular Resuscitation Research","authors":"J. Morrison, Hossam Abdou, Michael J. Richmond, M. Madurska, Noha N. Elansary","doi":"10.26676/jevtm.v40i(2).160","DOIUrl":"https://doi.org/10.26676/jevtm.v40i(2).160","url":null,"abstract":"Background: To demonstrate the utility and applicability of in vitro extracorporeal circuits in endovascular resuscitation research. \u0000Methods: The method for building an inexpensive in vitro extracorporeal circuit for endovascular resuscitation research is described. In this study, aortic cannulas and pump combinations were evaluated in the in vitro extracorporeal circuit. Then one aortic cannula and pump set up was evaluated in a post-mortem swine model. Flow data was collected and compared among groups. \u0000Results: The peristaltic pump generated the highest flow as compared to the other pump combinations at any given catheter size. The peristaltic pump combined with the 10 Fr cannula produced the highest flow overall at 2304 mL/min. This same combination produced a peak flow of 886 ml/min at the aortic root in the swine model. \u0000Conclusions: The flow generated in the swine model was less than half of that generated in the in vitro model. However, all flow was channeled through one outflow tract in the in vitro model whereas the swine aorta has several branches of outflow. As such, a 50% reduction in flow or greater is anticipated at the level of the aortic root. An in vitro extracorporeal circuit for endovascular research can be built for less than $10,000, with most of the materials being reusable, and can be used to generate representative data that may be anticipated in a swine model. \u0000 \u0000 ","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45890125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DCR and EVTM: The Future of Trauma Research and Training","authors":"M. Khan, B. Cotton, T. Hörer, J. Duschesne","doi":"10.26676/jevtm.v40i(2).163","DOIUrl":"https://doi.org/10.26676/jevtm.v40i(2).163","url":null,"abstract":"Special issue in collaboration with the Damage Control Resuscitation (DCR) group","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45806090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interventional Radiology Service During the COVID-19 Pandemic: Steps to Managing the Risk of Infection","authors":"A. Ierardi, A. Carnevale, M. Giganti, G. Carrafiello","doi":"10.26676/jevtm.v4i1.126","DOIUrl":"https://doi.org/10.26676/jevtm.v4i1.126","url":null,"abstract":"It is imperative to ensure the safety of healthcare workers in the angiographic room during the outbreak of the Covid-19 (coronavirus disease 2019). The selection criteria for Interventional radiology (IR) procedures, the preparation of the staff and angiographic suite, ventilation systems, intra- and post-procedural workflow optimization methods are detailed. The specific measures needed to protect occupational safety and health may result in higher costs, longer procedural times and greater technical problems. However, these precautions may help to minimize the spread of the Covid-19 among IR practitioners.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43009375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma Management During and After COVID-19","authors":"F. Coccolini","doi":"10.26676/jevtm.v4i1.125","DOIUrl":"https://doi.org/10.26676/jevtm.v4i1.125","url":null,"abstract":"Trauma management during COVID-19 and after. Experiences from Italy.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45896554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hate to Burst Your Balloon: Successful REBOA Use Takes More Than a Course.","authors":"Christina M Theodorou,&nbsp;Edgardo S Salcedo,&nbsp;Joseph J DuBose,&nbsp;Joseph M Galante","doi":"10.26676/jevtm.v4i1.106","DOIUrl":"https://doi.org/10.26676/jevtm.v4i1.106","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative endovascular balloon occlusion of the aorta (REBOA) is emerging as a viable intervention for hemorrhagic shock. Training surgeons to place the device is only part of the process. We hypothesize that implementation challenges extend beyond surgical skills training and initial REBOA use should not be expected to mirror published success.</p><p><strong>Methods: </strong>All REBOA placements from January 2016 to February 2017 at a level 1 trauma center were reviewed for opportunities for improvement. From September 2016 to February 2017, all patients meeting highest trauma activation criteria were reviewed against our REBOA algorithm to identify patients meeting criteria for REBOA placement but not undergoing the procedure.</p><p><strong>Results: </strong>REBOA was introduced at our institution in September 2015, with the first placement in January 2016. Trauma surgery, emergency department, and operating room staff underwent training. Nine patients had REBOA placed with six survivors. One patient underwent an unsuccessful REBOA attempt and died. Four patients had complications from REBOA. Eight additional patients met indications but did not undergo REBOA.</p><p><strong>Conclusions: </strong>Successful REBOA use requires more than teaching surgeons indications and techniques. For a successful REBOA program, system factors must be addressed. System processes must ensure equipment and procedures are standardized and familiar to all involved. Complications should be expected.</p>","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"4 1","pages":"21-29"},"PeriodicalIF":0.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316347/pdf/nihms-1599485.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38088743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Resuscitation and Trauma Management: Bleeding and Haemodynamic Control","authors":"T. Hörer, J. Dubose, T. Rasmussen, Joseph M. White","doi":"10.1007/978-3-030-25341-7","DOIUrl":"https://doi.org/10.1007/978-3-030-25341-7","url":null,"abstract":"","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":"28 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75340242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}