Role of endovascular peripheral vascular trauma: review article

Abstract

Traumatic peripheral vascular injuries are significant contributors to disability and mortality in both civilian and battlefield contexts. These injuries typically result from penetrating or blunt trauma, with iatrogenic arterial injury (IAI) also being a common pattern. Over time, the management of such injuries has improved across various environments and conflicts. Peripheral vascular injuries encompass a range of types, including vasospasm, contusion, intimal flaps, disruptions, hematomas, external compression, lacerations, transections, and focal wall defects. Clinical manifestations often involve shock due to severe bleeding and limb necrosis from tissue and organ ischemia. Diagnostic tools such as ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA) are invaluable for assessing these injuries, with angiography remaining the gold standard. Immediate control of hemorrhage and swift restoration of blood flow are primary treatment goals. The purpose of writing this literature review is to review in more depth the role of endovascular peripheral vascular trauma. The search for articles was conducted to address the problem formulation using five electronic databases of PubMed, EMBASE, Cochrane, Scopus and Google Scholar. The keywords used are “peripheral vascular trauma, endovascular, and open surgery Operative interventions include vascular suturing, ligation, wall repair, and reconstruction using prostheses or grafts. Endovascular techniques like embolization, balloon dilation, and covered stent implantation are also essential. While surgical procedures traditionally dominate treatment, endovascular approaches offer promising alternatives. They are proven to be safe, effective, and increasingly preferred for certain patients. In summary, rapid diagnosis and timely surgical or endovascular interventions are crucial for managing traumatic peripheral vascular injuries. Despite advancements, several unresolved issues require further investigation to refine treatment strategies and optimize outcomes.