Diretrizes brasileiras de diagnóstico e tratamento de lesões vasculares traumáticas
Brazilian guidelines on diagnosis and management of traumatic vascular injuries
Adenauer Marinho de Oliveira Góes Junior; José Gustavo Parreira; Gustavo Henrique Dumont Kleinsorge; Marcelo Bellini Dalio; Pedro Henrique Ferreira Alves; Francisco João Sahagoff de Deus Vieira Gomes; Walter Junior Boim de Araujo; Edwaldo Edner Joviliano; Julio Cesar Peclat de Oliveira
Resumo
Palavras-chave
Abstract
Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons. The possibility of limb loss due to vascular injuries must also be considered. In recent decades, the approach to vascular injuries has been significantly modified. Angiotomography has become the standard method for diagnosis, endovascular techniques are currently incorporated in treatment, and damage control, such as temporary shunts, is now the preferred approach for the patients sustaining physiological derangement. Despite the importance of this topic, few papers in the Brazilian literature have offered guidelines on vascular trauma. The Brazilian Society of Angiology and Vascular Surgery has developed Projetos Diretrizes (Guideline Projects), which includes this publication on vascular trauma. Since treating trauma patients is a multidisciplinary effort, the Brazilian Trauma Society (SBAIT) was invited to participate in this project. Members of both societies reviewed the literature on vascular trauma management and together wrote these guidelines on vascular injuries of neck, thorax, abdomen, and extremities.
Keywords
References
1 Kobayashi L, Coimbra R, Goes AMO, et al. AAST - WSES guidelines on diagnosis and management of abdominal vascular injuries. J Trauma Acute Care Surg. 2020;89(6):1197-211.
2 Kobayashi L, Coimbra R, Goes AMO, et al. AAST - WSES guidelines on diagnosis and management of peripheral vascular injuries. J Trauma Acute Care Surg. 2020;89(6):1183-96.
3 Hemingway JF, Desikan S, Dasari M, et al. Intraoperative consultation of vascular surgeons is increasing at a Major American Trauma Center. J Vasc Surg. 2021;74(5):1581-7.
4 DuBose JJ, Savage SA, Fabian TC, et al. The American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) registry: multicenter data on modern vascular injury diagnosis, management, and outcomes. J Trauma Acute Care Surg. 2015;78(2):215-22.
5 Branco BC, Musonza T, Long MA, et al. Survival trends after inferior vena cava and aortic injuries in the United States. J Vasc Surg. 2018;68(6):1880-8.
6 White PW, Gillespie DL, Feurstein I, et al. Sixty-Four Slice Multidetector Computed Tomographic Angiography in the Evaluation of Vascular Trauma. J Trauma. 2010;68(1):96-102.
7 Seamon MJ, Smoger D, Torres DM, et al. A Prospective Validation of a Current Practice: The Detection of Extremity Vascular Injury With CT Angiography. J Trauma. 2009;67(2):238-43.
8 Tisherman SA, Bokhari F, Collier B, et al. Clinical Practice Guideline: Penetrating Zone II Neck Trauma. J Trauma. 2008;64(5):1392-405.
9 Sperry JL, Moore EE, Coimbra R, et al. Western Trauma Association Critical Decisions in Trauma: penetrating neck trauma. J Trauma Acute Care Surg. 2013;75(6):936-40.
10 Han D, Mishra A, Batson S, Koller F, Iwuchukwu C. Management of a Penetrating Retrohepatic Vena Cava Injury. Am Surg. 2020;86(11):1573-4.
11 Góes AMO Jr, Simões Neto JFA, Abib SCV, de-Andrade MC, Ferraz TC. Vascular trauma in the Amazon: updating the challenge. Rev Col Bras Cir. 2018;45(4):e1844. PMid:30304097.
12 Costa CA, Souza JES, Araújo AO, Melo FAO, Costa IN, Klein PH. Pediatric vascular trauma in Manaus, Amazon - Brazil. Rev Col Bras Cir. 2016;43(5):320-6.
13 Migowski A, Fernandes MM. Diretrizes metodológicas: elaboração de diretrizes clínicas. Brasília, DF. Ministério da Saúde; 2016.
14 Biffl WL, Moore E, Offner P, Brega K, Franciose R, Burch J. Blunt carotid arterial injuries: implications of a new grading scale. J Trauma. 1999;47(5):845-53.
15 Lee WA, Matsumura JS, Mitchell RS, et al. Endovascular repair of traumatic thoracic aortic injury: Clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg. 2011;53(1):187-92.
16 Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6.
17 Dente CJ, Feliciano DV. Torso vascular trauma at an urban level-I trauma center. Perspect Vasc Surg Endovasc Ther. 2011;23(1):36-46.
18 White PW, Walker PF, Bozzay JD, Patel JA, Rasmussen TE, White JM. Management and outcomes of wartime cervical carotid artery injury. J Trauma Acute Care Surg. 2020;89(2S, Suppl 2):S225-30.
19 Feliciano DV. Penetrating cervical trauma. World J Surg. 2015;39(6):1363-72.
20 Hyre CE, Cikrit DF, Lalka SG, Sawchuk AP, Dalsing MC. Aggressive management of vascular injuries of the thoracic outlet. J Vasc Surg. 1998;27(5):880-4.
21 Gonçalves R, Saad R Jr. Vias de acesso aos grandes vasos mediastinais no trauma torácico. Rev Col Bras Cir. 2012;39(1):64-73.
22 Hampton M, Bew D, Edu S, Nicol A, Naidoo N, Navsaria P. An urban trauma centre experience with abdominal vena cava injuries. S Afr J Surg. 2016;54(1):36-41. PMid:28240494.
23 Chowdhury S, Almubarak SH, Binsaad KH, Mitra B, Fitzgerald M. Vertebral artery injury in major trauma patients in Saudi Arabia: a retrospective cohort study. Sci Rep. 2020;10(1):16199.
24 Alterman DM, Heidel RE, Daley BJ, et al. Contemporary outcomes of vertebral artery injury. J Vasc Surg. 2013;57(3):741-6, discussion 746.
25 Li W, D’Ayala M, Hirshberg A, Briggs W, Wise L, Tortolani A. Comparison of conservative and operative treatment for blunt carotid injuries: Analysis of the National Trauma Data Bank. J Vasc Surg. 2010;51(3):593-9, 599.e1-2.
26 Schellenberg M, Owattanapanich N, Cowan S, et al. Penetrating injuries to the vertebral artery: interventions and outcomes from US Trauma Centers. Eur J Trauma Emerg Surg. 2022;48(1):481-8.
27 Kray JE, Dombrovskiy VY, Vogel TR. Carotid artery dissection and motor vehicle trauma: patient demographics, associated injuries and impact of treatment on cost and length of stay. BMC Emerg Med. 2016;16(1):23.
28 Blitzer DN, Ottochian M, O’Connor J, et al. Penetrating injury to the carotid artery: characterizing presentation and outcomes from the National Trauma Data Ban. Ann Vasc Surg. 2020;67:192-9.
29 Almazedi B, Lyall H, Bhatnagar P, et al. Endovascular management of extra-cranial supra-aortic vascular injuries. Cardiovasc Intervent Radiol. 2014;37(1):55-68.
30 Starnes BW, Arthurs ZM. Endovascular management of vascular trauma. Perspect Vasc Surg Endovasc Ther. 2006;18(2):114-29.
31 Reva VA, Pronchenko AA, Samokhvalov IM. Operative management of penetrating carotid artery injuries. Eur J Vasc Endovasc Surg. 2011;42(1):16-20.
32 Demetriades D, Asensio JA, Velmahos G, Thal E. Complex problems in penetrating neck trauma. Surg Clin North Am. 1996;76(4):661-83.
33 Asensio JA, Kessler JJ 2nd, Kotaru TR, Kalamchi LD, Miljkovic SS, Dabestani PJ. Penetrating Internal and Common Carotid Artery Injuries Shunts versus no shunts during repair effect on neurological outcomes. Injury. 2021;52(2):266-73.
34 Mathew S, Smith BP, Cannon JW, Reilly PM, Schwab CW, Seamon MJ. Temporary arterial shunts in damage control: experience and outcomes. J Trauma Acute Care Surg. 2017;82(3):512-7.
35 Waller CJ, Cogbill TH, Kallies KJ, et al. Contemporary management of subclavian and axillary artery injuries: A Western Trauma Association multicenter review. J Trauma Acute Care Surg. 2017;83(6):1023-31.
36 Lichtenberger JP, Kim AM, Fisher D, et al. Imaging of combat-related thoracic trauma: review of penetrating trauma. Mil Med. 2018;183(3-4):e89-96.
37 Shalhub S, Starnes BW, Hatsukami TS, Karmy-Jones R, Tran NT. Repair of blunt thoracic outlet arterial injuries: an evolution from open to endovascular approach. J Trauma. 2011;71(5):E114-21.
38 Kou HW, Liao CH, Huang JF, et al. Eighteen years’ experience of traumatic subclavian vascular injury in a tertiary referral trauma center. Eur J Trauma Emerg Surg. 2019;45(6):973-8.
39 Abd El-Shafy I, Rosen LM, Prince JM, Letton RW, Rosen NG. Blunt traumatic scapular fractures are associated with great vessel injuries in children. J Trauma Acute Care Surg. 2018;85(5):932-5.
40 Beal AL, Ahrendt MN, Irwin ED, et al. Prediction of blunt traumatic injuries and hospital admission based on history and physical examination. World J Emerg Surg. 2016;11(1):46.
41 Haq AA, Restrepo CS, Lamus D, Ocazionez-Trujillo D, Vargas D. Thoracic venous injuries: an imaging and management overview. Emerg Radiol. 2016;23(3):291-301.
42 Shackford SR, Dunne CE, Karmy-Jones R, et al. The evolution of care improves outcome in blunt thoracic aortic injury: A Western Trauma Association multicenter study. J Trauma Acute Care Surg. 2017;83(6):1006-13.
43 Pang D, Hildebrand D, Bachoo P. Thoracic endovascular repair (TEVAR) versus open surgery for blunt traumatic thoracic aortic injury. Cochrane Database Syst Rev. 2015;(9):CD006642.
44 Nair R, Robbs JV, Muckart DJ. Management of penetrating cervicomediastinal venous trauma. Eur J Vasc Endovasc Surg. 2000;19(1):65-9.
45 Naidoo NG, Navsaria P, Beningfield SJ, Natha B, Cloete N, Gill H. Stent graft repair of subclavian and axillary vascular injuries: The Groote Schuur experience. S Afr J Surg. 2015;53(1):5-9.
46 Gonçalves R, Saad R Jr. Thoracic damage control surgery. Rev Col Bras Cir. 2016;43(5):374-81.
47 O’Connor JV, Adamski J. The diagnosis and treatment of non-cardiac thoracic trauma. J R Army Med Corps. 2010;156(1):5-14.
48 Giannakopoulos TG, Avgerinos ED. Management of peripheral and truncal venous injuries. Front Surg. 2017;4:46.
49 Mellnick VM, McDowell C, Lubner M, Bhalla S, Menias CO. CT features of blunt abdominal aortic injury. Emerg Radiol. 2012;19(4):301-7.
50 Tsai R, Raptis C, Schuerer DJ, Mellnick VM. CT appearance of traumatic inferior vena cava injury. AJR Am J Roentgenol. 2016;207(4):705-11.
51 Cullinane DC, Schiller HJ, Zielinski MD, et al. Eastern association for the surgery of trauma practice management guidelines for hemorrhage in pelvic fracture—update and systematic review. J Trauma. 2011;71(6):1850-68.
52 Sabat J, Hsu CH, Chu Q, Tan TW. The mortality for surgical repair is similar to ligation in patients with traumatic portal vein injury. J Vasc Surg Venous Lymphat Disord. 2019;7(3):399-404.
53 Beyer C, Zakaluzny S, Humphries M, Shatz D. Multidisciplinary management of blunt renal artery injury with endovascular therapy in the setting of polytrauma: a case report and review of the literature. Ann Vasc Surg. 2017;38:318.e11-6.
54 Lim KH, Park J. Successful conservative treatment of acute traumatic occlusions of the celiac artery and superior mesenteric artery. A case report emphasizing the importance of the visceral collateral circulations. Medicine (Baltimore). 2018;97(46):e13270.
55 Góes AMO Jr, Silva KTB, Furlaneto IP, Abib SCV. Lessons learned from treating 114 inferior vena cava injuries at a limited resources environment - a single center experience. Ann Vasc Surg. 2022;80:158-69.
56 Hymel A, Asturias S, Zhao F, et al. Selective versus nonselective embolization versus no embolization in pelvic trauma: A multicenter retrospective cohort study. J Trauma Acute Care Surg. 2017;83(3):361-7.
57 Howley IW, Stein DM, Scale TM. Outcomes and complications for portal vein or superior mesenteric vein injury: no improvement in the era of damage control resuscitation. Injury. 2019;50(12):2228-33.
58 Maithel S, Grigorian A, Kabutey NK, et al. Hepatoportal venous trauma: analysis of incidence, morbidity, and mortality. Vasc Endovascular Surg. 2020;54(1):36-41.
59 Rocca A, Andolfi E, Zamboli AGI, et al. Management of complications of first instance of hepatic trauma in a liver surgery unit: portal vein ligation as a conservative therapeutic strategy. Open Med (Wars). 2019;14(1):376-83.
60 Burlew CC, Moore EE, Smith WR, et al. Preperitoneal pelvic packing/ external fixation with secondary angioembolization: optimal care for life-threatening hemorrhage from unstable pelvic fractures. J Am Coll Surg. 2011;212(4):628-35, discussion 635-7.
61 D’Alessio I, Domanin M, Bissacco D, et al. Operative treatment and clinical outcomes in peripheral vascular trauma: the combined experience of two centers in the endovascular era. Ann Vasc Surg. 2020;62:342-8.
62 Mollberg NM, Wise SR, Banipal S, et al. Color-flow duplex screening for upper extremity proximity injuries: a low-yield strategy for therapeutic intervention. Ann Vasc Surg. 2013;27(5):594-8.
63 Mollberg NM, Wise SR, Keyashian B, et al. The incidence of acute venous injury as a result of proximity penetrating trauma screened with colour flow duplex ultrasound. Injury. 2014;45(1):192-6.
64 Colip CG, Gorantla V, LeBedis CA, Soto JA, Anderson SW. Extremity CTA for penetrating trauma: 10-year experience using a 64-detector row CT scanner. Emerg Radiol. 2017;24(3):223-32.
65 Inaba K, Branco BC, Reddy S, et al. Prospective evaluation of multidetector computed tomography for extremity vascular trauma. J Trauma. 2011;70(4):808-15.
66 Wani ML, Sheikh MT, Nayeem-Ul-Hassan, et al. Evaluating peripheral vascular injuries: is color doppler enough for diagnosis? Int Cardiovasc Res J. 2014;8(1):15-7. PMid:24757646.
67 Branco BC, Linnebur M, Boutrous ML, et al. The predictive value of multidetector CTA on outcomes in patients with below-the-knee vascular injury. Injury. 2015;46(8):1520-6.
68 Anderson SW, Foster BR, Soto JA. Upper extremity ct angiography in penetrating trauma: use of 64-section multidetector CT. Radiology. 2008;249(3):1064-73.
69 Peng PD, Spain DA, Tataria M, Hellinger JC, Rubin GD, Brundage SI. CT angiography effectively evaluates extremity vascular trauma. Am Surg. 2008;74(2):103-7.
70 Fortuna G, DuBose JJ, Mendelsberg R, et al. Contemporary outcomes of lower extremity vascular repairs extending below the knee: A multicenter retrospective study. J Trauma Acute Care Surg. 2016;81(1):63-70.
71 Góes AMO Jr, Abib SCV, Alves MTS, Ferreira PSVS, Andrade MC. Venous shunt versus venous ligation for vascular damage control: the immunohistochemical evidence. Ann Vasc Surg. 2017;41:214-24.
72 Shah SR, Wearden PD, Gaines BA. Pediatric peripheral vascular injuries: a review of our experience. J Surg Res. 2009;153(1):162-6.
73 Mommsen P, Zeckey C, Hildebrand F, et al. Traumatic extremity arterial injury in children: epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score. J Orthop Surg Res. 2010;5(1):25.
74 O’Banion LA, Dirks R, Farooqui E, et al. Popliteal scoring assessment for vascular extremity injuries in trauma. J Vasc Surg. 2021;74(3):804-13.
75 Montorfano MA, Montorfano LM, Quirante FP, Rodríguez F, Vera L, Neri L. The FAST D protocol: a simple method to rule out traumatic vascular injuries of the lower extremities. Crit Ultrasound J. 2017;9(1):8.
76 Branco BC, Naik-Mathuria B, Montero-Baker M, et al. Increasing use of endovascular therapy in pediatric arterial trauma. J Vasc Surg. 2017;66(4):1175-83.e1.
77 Mouawad NJ, Paulisin J, Hofmeister S, Thomas MB. Blunt thoracic aortic injury - concepts and management. J Cardiothorac Surg. 2020;15(1):62.
78 Sinha S, Patterson BO, Ma J, et al. Systematic review and meta-analysis of open surgical and endovascular management of thoracic outlet vascular injuries. J Vasc Surg. 2013;57(2):547-67.e8.
Submitted date:
03/15/2023
Accepted date:
06/15/2023
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email