The Safety And Effect Of Endovascular Interventional Minimally Invasive Techniques Treating For Peripheral Vessel Injury

ObjectiveThe injury of peripheral vessels is usually severe that has a risk of extremities loss and even life danger.Endovascular interventional minimally invasive techniques(IMIT)has become popular for its advantage of high rate of success and low risk of complication.I am aiming to evaluate the safety and efficacy of IMIT for treatment of the injury of peripheral vessels.Methods68 cases with injures of peripheral vessels including 46 cases of blunt injury,8 penetrating injury and 14 iatrogenic injury were retrospective analyzed in January 2010 to June 2015,from the department of vascular surgery,first affiliated hospital of Zhejiang University.Collection of demographic characteristics,clinical manifestations,surgery and follow-up of clinical information was done.All cases were confirmed by digital subtraction angiography and were treated by IMIT,including embolization with coils,catheter-directed thrombolysis and stent-graft.Efficacy and safety of IMIT treating for vessels of lower extremity injury was evaluated.ResultsAll 68 cases were cured and no amputation and death.The emboliztion technique was performed in 7 injured vessels cases,11 arteriovenous fistula cases and 20 pseudoaneurysm cases.Catheter-directed thrombolysis and bare metal stent implantation was performed in 25 cases with intimal damage.Covered stent-graft was used in 28 cases with vessels fracture.The technical success rate is 100%.After endovascular treatment,there are 13 patients with acute renal insufficient,22 patients with osteofascial compartment syndrome and 7patients with acute thrombosis were received active treatment.The average hospitalization time is 15d±3.7d days.63 patients were followed up for a rang from 6 to 71 months(mean 18.5 months).16 patients(23.8%)with intermittent claudication were received secondary treatment.The other ones were in good clinical condition,and no complications,such as significant stent stenosis(>50%),displacement,internal leakage,etc,were observed in the follow-up period.ConclusionIMIT can be applied in high-risk patients with peripheral vessel injury.The short-term results of endovascular management are encouraging with its high technical success rate and relatively low risk of complications.Further evaluation is satisfied for the high rate of primary patency rate.IMIT is a minimally invasive,safe and effective method in the treatment of peripheral vessels injury.