S. Chakraverty, I. Zealley, D. Kessel British Journal of Anaesthesia

Slides:

Advertisements

Similar presentations

Endovascular treatment of renal artery aneurysms and renal arteriovenous fistulas Zhongming Zhang, MD, Min Yang, MD, Li Song, MD, Xiaoqiang Tong, MD,

Advertisements

Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J

Progressive growth of a pelvic collection five years after endovascular aneurysm repair: An atypical presentation of an asymptomatic contained rupture

Pelvic vascular injuries

Pelvic angioembolization in trauma – Indications and outcomes

Reply from the authors British Journal of Anaesthesia

Successful endovascular management of an acute iliac venous injury during lumbar discectomy and anterior spinal fusion Joseph R. Schneider, MD, PhD,

Chris Burke, MD, Sherene Shalhub, MD, MPH, Benjamin W. Starnes, MD

Successful endovascular treatment of multiple mesenteric arterial aneurysms associated with alpha-1-antitrypsin deficiency Peter Gordon, MB, BCh, BDS,

Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J

Ruptured internal carotid aneurysm resulting from neurofibromatosis: Treatment with intraluminal stent graft Bertram L. Smith, MD, Carolyn E. Munschauer,

Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol–remifentanil total i.v. anaesthesia with desflurane anaesthesia

V. Jeganath, J.G. McElwaine, P. Stewart British Journal of Anaesthesia

Coronary artery bypass grafting in the awake patient combining high thoracic epidural and femoral nerve block: first series of 15 patients N. Noiseux,

Xiaobai Wang, MD, Yan Zhang, MD, Chengzhi Li, MD, Hong Zhang, MD

True lumen re-entry devices facilitate subintimal angioplasty and stenting of total chronic occlusions: Initial report Donald L. Jacobs, MD, Raghunandan.

Traumatic renal vein pseudoaneurysm

Patients with head and neck cancers and associated postirradiated carotid blowout syndrome: Endovascular therapeutic methods and outcomes Feng-Chi Chang,

Triaging the right patient to the right place in the shortest time

Lower extremity arterial injury: Results of 550 cases and review of risk factors associated with limb loss H.M. Hafez, PhD, FRCSa, J. Woolgar, FRCSb,

Autologous vein–covered stent for the endovascular management of an iliac artery– ureteral fistula: Case report and review of the literature D.Brent Kerns,

Christopher L. Stout, MD, Eric C. Scott, MD, Gordon K

Thrombus in left ventricle discovered by transoesophageal echocardiography (TOE) in a patient with acute abdomen: how TOE can be crucial for decision-making.

M. R. Sapoval, MD, B. Beyssen, MD, J. Y. Pagny, MD, E

M.E. Hudson, J.E. Chelly, J.R. Lichter British Journal of Anaesthesia

Distal internal iliac artery embolization: A procedure to avoid

Endovascular embolization prior to surgical resection of symptomatic intralobar pulmonary sequestration in an adult Jernej Avsenik, Tomaž Štupnik, Peter.

Deming Wang, MD, Lixin Su, PhD, Yifeng Han, MD, Xindong Fan, MD

Successful off-label use of the GORE EXCLUDER Iliac Branch Endoprosthesis to preserve gluteal perfusion during staged endovascular repair of bilateral.

Jonathan J. Sexton, MD, David R. Whittaker, MD

Vladimir Neychev, MD, PhD, Emilia Krol, MD, Alan Dietzek, MD

Ultrasound standard for lumbar plexus block

Pharmacodynamic response modelling of arterial blood pressure in adult volunteers during propofol anaesthesia C. Jeleazcov, M. Lavielle, J. Schüttler,

Vascular complications of cardiac catheterization

Diastolic dysfunction, cardiopulmonary bypass, and atrial fibrillation after coronary artery bypass graft surgery C.M. Ashes, M. Yu, M. Meineri, R. Katznelson,

R. Harika, K. Bermas, C. Hughes, A. Al-Khafaji, M. Iyer, D.J. Wallace

Endovascular treatment of ruptured axillary and large internal mammary artery aneurysms in a patient with Marfan syndrome Jessica F. Rose, DO, Layla.

Isolated spontaneous dissection of the splanchnic arteries

Blunt abdominal aortic injury

First experience using intraoperative contrast-enhanced ultrasound during endovascular aneurysm repair for infrarenal aortic aneurysms Reinhard Kopp,

Endovascular aneurysm repair for ruptured abdominal aortic aneurysm: The Albany Vascular Group approach Manish Mehta, MD, MPH Journal of Vascular Surgery

Therapeutic embolization of an internal mammary artery damaged by placement of a central venous catheter G. Abbott, P. Evans British Journal of Anaesthesia

Endovascular treatment of renal artery aneurysms and renal arteriovenous fistulas Zhongming Zhang, MD, Min Yang, MD, Li Song, MD, Xiaoqiang Tong, MD,

Hybrid Endovascular Exclusion of a Bleeding Innominate Artery Pseudoaneurysm in a Patient With No Open Surgical Options Asad J. Choudhry, MBBS, Palma.

Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft Gary Lemmon, MD, Andrew Barleben, MD, Peter.

Harshal Broker, MD, G. Patrick Clagett, MD Journal of Vascular Surgery

K. Miyagi, M. Mulchandani, D.J.B. Marks, M. Mohamed EJVES Extra

Acute traumatic coagulopathy: pathophysiology and resuscitation

Aortic type B dissection with acute expansion of iliac artery aneurysm in previous endovascular repair with iliac branched graft Raffaele Pulli, MD,

Damage control surgery in the era of damage control resuscitation

General anaesthesia with laryngeal mask airway may cause recurrence of pneumocephalus in a patient with head injury I Gurajala, M Azharuddin, R Gopinath

Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients.

Peripheral Arterial Lesions in Patient with Sickle Cell Disease

P. Fogarty Mack British Journal of Anaesthesia

Michel Lacombe, MD Journal of Vascular Surgery

H. Edward Garrett, MD, Robert W. Heidepriem, MD, L. Paul Broadbent, MD

Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft Gary Lemmon, MD, Andrew Barleben, MD, Peter.

Endoleaks after endovascular graft treatment of aortic aneurysms: Classification, risk factors, and outcome Reese A. Wain, MD, Michael L. Marin, MD,

James L. Frank, MD a, Barry L. Reimer, MD b, John J. Raves, MD, FAGS a

True superior gluteal artery aneurysm

Endovascular stent graft exclusion of a thoracic arteriovenous malformation in a patient with Cobb syndrome Cindy Huynh, MD, Vivian Gahtan, MD, Robert.

Karthikeshwar Kasirajan, MD, Peter A Schneider, MD

Joshua Sylvan, Roy K. Greenberg, MD, Tara M. Mastracci, MD, Matthew J

Endovascular repair of stent graft collapse by stent-protected angioplasty using a femoral-brachial guidewire Drosos Kotelis, MD, Ruben Lopez-Benitez,

Levosimendan pre-treatment improves outcomes in patients undergoing coronary artery bypass graft surgery† L. Tritapepe, V. De Santis, D. Vitale, F. Guarracino,

Endovascular repair of thoracic aortic injury after spinal instrumentation Paul Claiborne, MD, Alexandros Mallios, MD, Kevin Taubman, MD, John Blebea,

Circadian distribution of sleep phases after major abdominal surgery

Endovascular repair of thoracic aortic injury after spinal instrumentation Paul Claiborne, MD, Alexandros Mallios, MD, Kevin Taubman, MD, John Blebea,

Successful endovascular treatment of hemosuccus pancreaticus due to splenic artery aneurysm associated with segmental arterial mediolysis Hideaki Obara,

Wee L. , Barron J. , Toye R. British Journal of Anaesthesia

Presentation transcript:

Damage control radiology in the severely injured patient: what the anaesthetist needs to know S. Chakraverty, I. Zealley, D. Kessel British Journal of Anaesthesia Volume 113, Issue 2, Pages 250-257 (August 2014) DOI: 10.1093/bja/aeu203 Copyright © 2014 The Author(s) Terms and Conditions

Fig 1 A 75-yr-old female pedestrian injured in road traffic collision. Permissive hypotension but unstable. (a) Sagittal reformat of MDCT showing ruptured internal iliac artery at its origin form common iliac artery (arrowed). Extensive pelvic haematoma and fractures. (b) Stent-graft placement (arrowed) lining iliac artery with immediate AP restoration. Time from ED to CT 45 min. Time from the patient coming off CT table to completion of stent-graft 15 min. In retrospect, balloon occlusion of the aorta or iliac artery while in CT could have been considered. Interval cholecystectomy at 14 days for presumptively ischaemic perforation. Patient died at 30 days from multi-organ failure. British Journal of Anaesthesia 2014 113, 250-257DOI: (10.1093/bja/aeu203) Copyright © 2014 The Author(s) Terms and Conditions

Fig 2 Diagram to conceptualize the benefit of damage control surgery (DCS) over standard surgery in obtaining earlier haemostasis. The use of MDCT can shorten this overall time as it will guide DCS (or IR) to achieve directed haemostasis more quickly, even if the start of the therapeutic manoeuvre is slightly later than it might otherwise be. British Journal of Anaesthesia 2014 113, 250-257DOI: (10.1093/bja/aeu203) Copyright © 2014 The Author(s) Terms and Conditions

Fig 3 A 40-yr-old male injured in road traffic collision. Permissive hypotension but unstable. (a) Coronal CT reformat shows splenic contusion, active extravasation from the spleen (arrowed), and free intraperitoneal blood. (b) Pre-embolization image at angiography. The patient had splenic artery embolization to area of vascular injury (arrowed) with immediate AP restoration. Time from ED to CT 60 min. Time from coming off CT table to last splenic artery coil 15 min. Temporary ileus in hospital. Patient discharged well at 14 days. If procedure had not been as straightforward, a more proximal splenic artery embolization could have been performed. British Journal of Anaesthesia 2014 113, 250-257DOI: (10.1093/bja/aeu203) Copyright © 2014 The Author(s) Terms and Conditions

Fig 4 A 22-yr-old female injured in road traffic collision. Extensive pelvic injury, metabolic upset, and coagulopathy on delayed arrival. Extensive pelvic haematoma with no bleeding site identified, presumably due to transient loss of blood pressure control. Note size of femoral arteries (arrowed) below pelvic binder which might render access difficult even with ultrasound control. Time from ED to CT 25 min. CT also showed irretrievable head injury and resuscitation was abandoned. British Journal of Anaesthesia 2014 113, 250-257DOI: (10.1093/bja/aeu203) Copyright © 2014 The Author(s) Terms and Conditions