Over the past several decades,
catheter-based and
endovascular techniques have been used with increasing frequency for the management of
trauma. This is particularly true for the management of solid organ injury and
vascular injuries resulting from pelvic fracture with the use of embolization techniques for successful arrest of active
hemorrhage. Likewise, there is a large body of literature regarding the management of acute traumatic
vascular injuries involving traditional open surgical techniques. Currently, however, there is sparse literature on the management of vascular
trauma with
endovascular techniques. The endovascular management of vascular
trauma seems particularly appealing in the management of blunt truncal
injuries, especially in the setting of severe concomitant brain and
lung injury. Extremity and
neck injuries are probably best handled by traditional methods of surgical proximal and distal control, the exception to this being base of skull
injuries where there is no ability for distal vessel control, and "watershed" areas between the trunk and extremities where proximal vascular control can be quite difficult. This chapter reviews current literature with regard to the endovascular management of traumatic
vascular injuries with regions being broadly defined as neck, trunk, and extremity.