New technologies for vascular injury

Standard therapy for vascular injuries has historically consisted of surgical exposure of the injured site and placement of a bypass graft. Surgical treatment can be demanding due to the inaccessibility of the vessels involved, distortion of the anatomy, or the presence of venous hypertension. Endovascular techniques are becoming a viable alternative in the field of vascular trauma. Coil embolization, stent placement, and stented grafts are well-documented adjuncts to open surgery. All these techniques involve the use of a catheter guidewire under fluoroscopic control. In addition to using minimal access, the major advantage of endovascular repair for vascular trauma is the ability to repair the lesion from a remote access site, thereby avoiding a hostile field. This article reviews the literature on endovascular techniques with special emphasis on stented grafts. Although these independent series were frequently reported in a noncontrolled, nonstandardized fashion, favorable results have been obtained. In the future, endovascular techniques are likely to have an increasing role in the treatment of traumatic vascular injuries.