Journal of EndoVascular Resuscitation and Trauma Management最新文献

{"title":"Successful Control of Massive Vaginal Bleeding with Resuscitative Endovascular Balloon Occlusion of the Aorta and Pelvic Packing","authors":"Emre Özlüer, Çağaç Yetiş, E. Sayın, M. Avcil","doi":"10.26676/jevtm.v3i3.92","DOIUrl":"https://doi.org/10.26676/jevtm.v3i3.92","url":null,"abstract":"Gynecological malignancies may present as life-threatening vaginal bleeding. Pelvic packing and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may be useful along with conventional vaginal packing when in terms of control of the hemorrhage. Emergency physicians should be able to perform these interventions promptly in order to save their patients from exsanguination.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49633035","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":"Selected abstracts accepted for the EVTM St Petersburg meeting 7th June 2019","authors":"V. Reva","doi":"10.26676/JEVTM.V3I2.94","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.94","url":null,"abstract":"Selected abstracts accepted for the EVTM St Petersburg meeting 7th June 2019","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47725552","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":"Introduction to the Sixth Edition of the JEVTM","authors":"I. Samokhvalov","doi":"10.26676/JEVTM.V3I2.93","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.93","url":null,"abstract":"Dear Readers, \u0000Welcome to the sixth edition of the JEVTM! \u0000In 1866, the Great Russian surgeon and scientist Nikolai Pirogov wrote: “A new era for surgery will begin, if we can quickly and surely control the flow in a major artery without exploration and ligation”. This era has now arrived and it is called EVTM! Our mission has been to maximize the benefits of endovascular technologies for trauma and bleeding patients: from the first attempts of REBOA by Carl Hughes in the 1950s with hand-made aortic balloon occlusion catheters used in our department since the early 1990s to modern successful cases of out-of-hospital REBOA use in combat and civilian casualties for ruptured aneurysms, post-partum hemorrhage and trauma. \u0000In this edition, you will find articles related to a new strategy of damage control interventional radiology (DCIR), partial REBOA in elderly patients and in ruptured aortic aneurysms, thrombolysis for trauma-associated IVC thrombosis, simulation models for training of REBOA, contemporary utilization of Zone III REBOA and more. \u0000As a continuation of EVTM development, Russian surgeons, emergency physicians, anesthetists, and others will be involved in the world of EVTM, participating in expanding the horizons of trauma care and cultivating the endovascular mindset. Also published in this edition are some of the abstracts that will be presented at the EVTM conference in Russia, St. Petersburg (7/06/2019). More than 35 oral and 30 poster presentations will make this conference a scientific feast for our audience! By adopting these new techniques for bleeding management, we are following Pirogov’s motto – to achieve fast endovascular hemorrhage control – which can only be done as part of an interdisciplinary approach. \u0000  \u0000We look forward to seeing you in Saint Petersburg at the EVTM-Russia meeting! \u0000www.evtm.org","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49086372","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":"Partial Aortic Occlusion using Resuscitative Endovascular Balloon Occlusion of the Aorta (P-REBOA) in Ruptured Abdominal Aortic Aneurysm","authors":"F. Cheema, Aksim Rivera, Amit R. Shah, S. Teperman, M. Stone, Edward Chao","doi":"10.26676/JEVTM.V3I2.87","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.87","url":null,"abstract":"Ruptured abdominal aortic aneurysm is often a fatal event without immediate intervention for the associated hemorrhagic shock and impending cardiovascular collapse. We report a case of a ruptured abdominal aortic aneurysm managed with partially occlusive resuscitative endovascular balloon occlusion of the aorta (P-REBOA) as a means to gain proximal control, tailor blood pressure goals, while allowing time to obtain access and repair the ruptured aneurysm.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45772431","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":"Successful Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in an Octogenarian Trauma Patient","authors":"T. Wannatoop, Chidpong Siritongtaworn, K. Keorochana, Thongsak Wongpongsalee, Raywat Chunhasuwankul","doi":"10.26676/JEVTM.V3I2.84","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.84","url":null,"abstract":"- Background: To demonstrate how to perform successful REBOA/ABO in extreme elderly patient \u0000- Materials and methods: A case report \u0000- Results: \u0000A 86-year old male, he was struck by car and transferred to Level I Trauma center at Siriraj hospital after injury for 30 minutes. Arrival clinical signs were coma and hypotension, lowest SBP was 50 mmHg. Primary survey found unstable pelvic fracture and severe head injury. We did REBOA at Zone I via left common femoral artery which aim to do partial balloon technique by inflation with 15-18 mL and arterial line monitoring for goal SBP around 100-120 mmHg due to his extreme age and associated traumatic brain injury. After CT scan showed no intra-abdominal injury, we did reposition the balloon to zone III under fluoroscopy. Unexpectedly, during deflation the balloon before removal, we found fresh blood through the balloon port, then ruptured balloon was suspected and confirmed with aortography. We immediately converted to remove by open technique due to balloon was failed to shrinkage through 7-Fr sheath. We reviewed the CT scan was shown calcified plaque along aorta and arteries which could be the cause of ruptured balloon. Throughout all procedures to stop bleeding which are pelvic external fixation, preperitoneal pelvic packing and embolization at right internal iliac artery, patient was given PRC only 4 units and no inotropic support to stabilizing patient. Total inflation time was 167 minutes with partial and intermittent REBOA technique. ICU Admission lab showed normal renal and liver function. \u0000- Conclusion : \u0000To perform ABO/REBOA in extreme elderly trauma patient, the partial balloon technique with goal SBP to balance between associated injury in polytrauma patient is very essential. The specific concern in this group would be related with reserve function and the changing of vascular access. Techniques for detection and solving the uneventful conditions should be prepared and learnt to successfully save the elderly patient.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42340052","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":"Thrombolysis for Trauma-Associated Inferior Vena Caval Thrombosis can be Safe in Selected Patients: A Case Report and Review of the Literature","authors":"C. Swain, M. Macanovic, R. Faulconer","doi":"10.26676/JEVTM.V3I2.85","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.85","url":null,"abstract":"Traumatic injury results in significant physiological changes that place patients at elevated risk for venous thromboembolism (VTE). Percutaneous catheter-directed thrombolysis has been recommended as a first-line therapy for treatment of VTE but is relatively contraindicated in trauma cases due to increased risk of bleeding. The authors present a case to support the opinion that thrombolysis for trauma-associated inferior vena caval thrombosis can be safe in selected patients, with discussion of existing literature.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44917365","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":"Gossypiboma: Is it always what it appears to be? A Rare Complication in Everyday Practice","authors":"D. Sheffer","doi":"10.26676/JEVTM.V3I2.90","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.90","url":null,"abstract":"Background: While the management of liver injury is usually conservative, the major indication for surgery remains hemodynamic instability. Different techniques are described for hemostasis in cases which require surgery. Several commercial hemostatic agents are readily available and can be used as an adjunct after the repair of the liver injuries. One of the most well-known local agents is gelfoam, which is used in multiple fields of surgery. The aim of this work is to present a very rare complication while using gelfoam, mimicking gossipiboma. \u0000Design: A case study describing a hemodynamically unstable patient who suffered from a penetrating liver injury. Hemostasis was achieved by liver suture and Gelfoam with subsequent angioembolization. In the post-operative period, the patient demonstrated signs of intraabdominal sepsis due to liver abscess. Repeated attempts of percutaneous drainage failed, and all cultures were negative. Due to a strong suspicion of a forgotten abdominal pad (gossipiboma), the patient was operated on and the object was removed. The final pathological report showed no textile in the specimen, the findings were compatible with a piece of gelfoam without any signs of absorption. \u0000Discussion and Conclusions: Commonly used hemostatic agents are made of gelatin gelfoams, microfibrillar collagen, thrombin, and fibrin sealant. Gelfoam is available in sponge or powder form. The sponge can be left in place and is supposed to be completely absorbed in four to six weeks. We found in the relevant literature only one case of gelfoam use related to granuloma formation. In our case, the radiologic findings in the liver were interpreted as an abscess. The suspicion of a foreign body was raised only during his second admission and thus forced us to operate. There is no clear reason why the piece of gelfoam wasn’t absorbed in that time period. Our assumption is that post angiography liver ischemia may have disturbed the process of fibrin destruction. The possibility of such condition should be considered when liver angioembolization is performed adjunct to surgical hemostasis using gelfoam.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43368201","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":"Contemporary Utilization of Zone III REBOA for Temporary Control of Pelvic and Lower Junctional Hemorrhage Reliably Achieves Hemodynamic Stability in Severely Injured Patients","authors":"J. Pasley","doi":"10.26676/JEVTM.V3I2.89","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I2.89","url":null,"abstract":"Background: Aortic occlusion is a valuable adjunct for management of traumatic pelvic and lower extremity junctional hemorrhage. \u0000Methods: The American Association for the Surgery of Trauma's Aortic Occlusion in Resuscitation for Trauma and Acute Care Surgery registry was reviewed for patients requiring Zone III resuscitative endovascular balloon occlusion of the aorta (REBOA) from eight verified trauma centers. After excluding patients in arrest, demographics, elements of treatment and outcomes were identified. \u0000Results: From Nov 2013 – Dec 2016, 30 patients had Zone III REBOA placed. Median age was 41.0 (IQR 38); median ISS 41.0 (IQR 12). Hypotension (SBP < 90mm Hg) was present on admission in 30.0% and tachycardia (HR > 100 bpm) in 66.7%. Before REBOA placement, vital signs changed in this cohort with hypotension in 83.3% and tachycardia noted in 90%. Median initial pH was 7.14 (IQR 0.22), and median admission lactate 9.9 mg/dL (IQR 5). Pelvic binders were utilized in 40%. Occlusion balloon devices included Coda™ (70%), ER-REBOA™ (13.3%), Reliant™ (10%).  After REBOA, hemodynamics improved in 96.7% and stability (BP consistently > 90 mm Hg) was achieved in 86.7%. Median duration of REBOA was 53.0 mins (IQR 112). Median PRBC and FFP requirements were 19.0 units (IQR (17) and 17.0 units (IQR 14), respectively. One amputation unrelated to REBOA utilization was required. Systemic complications included AKI (23.3%) and MODS (10%). REBOA specific complications included groin hematoma (3.3%) and distal thromboembolization (16.7%). Survival to discharge was 56.7%, with in-hospital deaths occurring in the ED 7.7%, OR 23.1%, ICU 69.2%. \u0000Conclusions: This review discusses the specifics of the contemporary use of Zone III REBOA placement as well as local and systemic complications for patients in extremis with pelvic/junctional hemorrhage. Further review is required determine optimal patient selection. \u0000Level of Evidence: Level IV \u0000Study Type: Therapeutic \u0000Key Words \u0000  \u0000Zone III REBOA, Pelvic Bleeding, Junctional Hemorrhage","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45956534","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 Management following Unintentional Subclavian Artery Injury during Central Venous Catheter Placement","authors":"D. McGreevy","doi":"10.26676/JEVTM.V3I1.88","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I1.88","url":null,"abstract":"Background \u0000Traumatic injury to the subclavian artery during central venous catheter (CVC) placement is rare but can be catastrophic. Standard open surgical treatment is challenging and associated with significant complications. Presented is a case of endovascular treatment of these injuries and associated complications. \u0000Methods and Results \u0000This is a description of the endovascular repair of a subclavian artery injury during CVC placement at Örebro University Hospital. \u0000Conclusion \u0000This case report suggests that endovascular repair of subclavian artery injuries a less invasive and may decrease the morbidity and mortality associated with open surgical repair.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42585210","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 resuscitation and Trauma Management (EVTM) in the Hybrid Emergency Room System (HERS)","authors":"Y. Matsumura, J. Matsumoto, Kaori Ito, Hiroyuki Ohbe, T. Kinoshita, K. Hayashida, T. Funabiki, K. Yamakawa, S. Kushimoto, S. Fujimi","doi":"10.26676/JEVTM.V3I1.80","DOIUrl":"https://doi.org/10.26676/JEVTM.V3I1.80","url":null,"abstract":"The concept of EndoVascular resuscitation and Trauma Management (EVTM) has recently been proposed to refer to the use of endovascular techniques for resuscitation, haemorrhage control, and definitive trauma management. Although the popularity of resuscitative endovascular balloon occlusion of the aorta (REBOA) has been growing, the use of the EVTM or CT imaging is still limited in hemodynamically unstable patients. To overcome the current limitations, the Hybrid Emergency Room System (HERS) was introduced in 2011. HERS consists of an operating table with an angiographic C-arm and a sliding CT scanner system in the resuscitation area, which allows all emergency diagnostic and therapeutic interventions without relocating the patient. This paper deals with current limitations of EVTM and proposes solutions with HERS. \u0000In the HERS environment, patients can undergo IR in the resuscitation room, which may expand the indications of IR to include hemodynamically unstable patients. HERS can also reduce CT scanning time to identify unexpected injuries or traumatic brain injury. It also allows prompt neurosurgical intervention simultaneously with haemorrhage control. REBOA is a viable adjunct treatment for refractory haemorrhagic shock but its procedure-related complications must be considered. REBOA can be performed more safely, rapidly, and accurately in HERS, followed by immediate definitive haemostasis. In addition, HERS may safely extend the application of REBOA-CT to identify accurate injury site. \u0000HERS may be an ideal EVTM solution for the trinity of surgery, endovascular treatment, and imaging in trauma care. We will continue to explore the most radical and safest EVTM in the HERS environment.","PeriodicalId":41233,"journal":{"name":"Journal of EndoVascular Resuscitation and Trauma Management","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47109747","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}