TY - JOUR
T1 - Direct-site endovascular repair (DSER)
T2 - A novel approach to vascular trauma
AU - Davidson, Anders J.
AU - Neff, Lucas P.
AU - DuBose, Joseph J.
AU - Sampson, James B.
AU - Abbot, Christopher M.
AU - Williams, Timothy K.
N1 - Publisher Copyright:
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.).
PY - 2016
Y1 - 2016
N2 - Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use. To address these challenges, we present a technique, using an off-the-shelf endovascular device, for treatment of peripheral arterial injuries. Direct-site endovascular repair (DSER) is an open vascular surgical reconstruction technique using conventional endovascular stent grafts to create a "sutureless" anastomosis. We believe this technique to be a valuable adjunct to current repair options. The values of this technique are that it is (1) rapid, (2) of low technical complexity, (3) requires very little equipment, and (4) may offer extended durability in damage control scenarios. We describe three patients where this technique was used. In the first case, the technique was used to provide a temporary arterial shunt in a patient with a local infection and arterial disruption. In the second case, DSER was used for definitive repair of an injured artery after penetrating trauma. The third case involves DSER for definitive of both an artery and vein after penetrating trauma. (J Trauma Acute Care Surg. 2016;81: S138-S143.
AB - Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use. To address these challenges, we present a technique, using an off-the-shelf endovascular device, for treatment of peripheral arterial injuries. Direct-site endovascular repair (DSER) is an open vascular surgical reconstruction technique using conventional endovascular stent grafts to create a "sutureless" anastomosis. We believe this technique to be a valuable adjunct to current repair options. The values of this technique are that it is (1) rapid, (2) of low technical complexity, (3) requires very little equipment, and (4) may offer extended durability in damage control scenarios. We describe three patients where this technique was used. In the first case, the technique was used to provide a temporary arterial shunt in a patient with a local infection and arterial disruption. In the second case, DSER was used for definitive repair of an injured artery after penetrating trauma. The third case involves DSER for definitive of both an artery and vein after penetrating trauma. (J Trauma Acute Care Surg. 2016;81: S138-S143.
KW - Endovascular
KW - Open arterial repair
KW - Shunt
KW - Vascular trauma
UR - http://www.scopus.com/inward/record.url?scp=84986236341&partnerID=8YFLogxK
U2 - 10.1097/TA.0000000000001241
DO - 10.1097/TA.0000000000001241
M3 - Article
C2 - 27768661
AN - SCOPUS:84986236341
SN - 2163-0755
VL - 81
SP - S138-S143
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 5
ER -