Role of Interventional Radiology in the Management of Venous Trauma

Abstract

Traumatic injury to the large, central venous vasculature, although rare, is associated with high morbidity and mortality rates. Conventional open surgical treatment by repair or ligation can be technically challenging in anatomically difficult areas to expose. Furthermore, open surgical approach can release tension on the venous injury and result in uncontrollable bleeding. Endovascular techniques such as stenting and embolization can be used effectively for the treatment of traumatic venous injury. This article will discuss the morbidity and mortality associated with traumatic venous injuries, venous anatomy, endovascular treatment options, and management of traumatic venous injury.

Keywords

venous trauma - stenting - hemorrhage - interventional radiology

Publication History

Article published online:
20 December 2022

• References

• 1 Azizzadeh A, Pham MT, Estrera AL, Coogan SM, Safi HJ. Endovascular repair of an iatrogenic superior vena caval injury: a case report. J Vasc Surg 2007; 46 (03) 569-571
• 2 Brant J, Peebles C, Kalra P, Odurny A. Hemopericardium after superior vena cava stenting for malignant SVC obstruction: the importance of contrast-enhanced CT in the assessment of postprocedural collapse. Cardiovasc Intervent Radiol 2001; 24 (05) 353-355
• 3 Martin M, Baumgartner I, Kolb M, Triller J, Dinkel H-P. Fatal pericardial tamponade after Wallstent implantation for malignant superior vena cava syndrome. J Endovasc Ther 2002; 9 (05) 680-684
• 4 Kabutey N-K, Rastogi N, Kim D. Conservative management of iatrogenic superior vena cava (SVC) perforation after attempted dialysis catheter placement: case report and literature review. Clin Imaging 2013; 37 (06) 1138-1141
• 5 Panduranga P, Thomas E, Al-Maskari S, Al-Farqani A. Giant superior vena caval aneurysm in a post-Glenn patient. Interact Cardiovasc Thorac Surg 2012; 14 (06) 878-879
• 6 Varma PK, Dharan BS, Ramachandran P, Neelakandhan KS. Superior vena caval aneurysm. Interact Cardiovasc Thorac Surg 2003; 2 (03) 331-333
• 7 Griviau L, Chevallier O, Favelier S, Pottecher P, Gehin S, Loffroy R. Endovascular management of a large aneurysm of the superior vena cava involving internal thoracic vein with remodeling technique. Quant Imaging Med Surg 2016; 6 (03) 315-317
• 8 Giannakopoulos TG, Avgerinos ED. Management of peripheral and truncal venous injuries. Front Surg 2017; 4: 46-46
• 9 Huerta S, Bui TD, Nguyen TH, Banimahd FN, Porral D, Dolich MO. Predictors of mortality and management of patients with traumatic inferior vena cava injuries. Am Surg 2006; 72 (04) 290-296
• 10 Netto FACS, Tien H, Hamilton P. et al. Diagnosis and outcome of blunt caval injuries in the modern trauma center. J Trauma 2006; 61 (05) 1053-1057
• 11 Buckman RF, Pathak AS, Badellino MM, Bradley KM. Injuries of the inferior vena cava. Surg Clin North Am 2001; 81 (06) 1431-1447
• 12 Cole K, Shadis R, Sullivan Jr TR. Retrohepatic hematoma causing caval compression after blunt abdominal trauma. J Surg Educ 2009; 66 (01) 48-50
• 13 Matthees NG, Mankin JA, Kalinkin OM, Richardson RR. A rare opportunity for conservative treatment in a case of blunt trauma to the supradiaphragmatic inferior vena cava. J Surg Case Rep 2013; 2013 (11) rjt092
• 14 Tsai R, Raptis C, Schuerer DJ, Mellnick VM. CT appearance of traumatic inferior vena cava injury. AJR Am J Roentgenol 2016; 207 (04) 705-711
• 15 Rosengart MR, Smith DR, Melton SM, May AK, Rue III LW. Prognostic factors in patients with inferior vena cava injuries. Am Surg 1999; 65 (09) 849-855 , discussion 855–856
• 16 Piffaretti G, Carrafiello G, Piacentino F, Castelli P. Traumatic IVC injury repair: the endovascular alternative. Endovasc Today. 2013; (November): 39-44
• 17 Cheaito A, Tillou A, Lewis C, Cryer H. Management of traumatic blunt IVC injury. Int J Surg Case Rep 2016; 28: 26-30
• 18 Buckman Jr RF, Miraliakbari R, Badellino MM. Juxtahepatic venous injuries: a critical review of reported management strategies. J Trauma 2000; 48 (05) 978-984
• 19 Holly BP, Steenburg SD. Multidetector CT of blunt traumatic venous injuries in the chest, abdomen, and pelvis. Radiographics 2011; 31 (05) 1415-1424
• 20 Han BK, Im J-G, Jung JW, Chung MJ, Yeon KM. Pericaval fat collection that mimics thrombosis of the inferior vena cava: demonstration with use of multi-directional reformation CT. Radiology 1997; 203 (01) 105-108
• 21 Hewett JJ, Freed KS, Sheafor DH, Vaslef SN. Contained hematoma (pseudoaneurysm) of the inferior vena cava associated with blunt abdominal trauma. AJR Am J Roentgenol 1999; 172 (04) 1144-1144
• 22 Hewett JJ, Freed KS, Sheafor DH, Vaslef SN, Kliewer MA. The spectrum of abdominal venous CT findings in blunt trauma. AJR Am J Roentgenol 2001; 176 (04) 955-958
• 23 Hines J, Katz DS, Goffner L, Rubin GD. Fat collection related to the intrahepatic inferior vena cava on CT. AJR Am J Roentgenol 1999; 172 (02) 409-411
• 24 Parke CE, Stanley RJ, Berlin AJ. Infrarenal vena caval injury following blunt trauma: CT findings. J Comput Assist Tomogr 1993; 17 (01) 154-157
• 25 Sheafor DH, Foti TM, Vaslef SN, Nelson RC. Fat in the inferior vena cava associated with caval injury. AJR Am J Roentgenol 1998; 171 (01) 181-182
• 26 Singh SP, Canon CL, Treat RC, Crowe DR, O'Dell II RH, Koehler RE. Traumatic dissection of the inferior vena cava. AJR Am J Roentgenol 1997; 168 (01) 253-254
• 27 Mattox KL, Feliciano DV, Burch J, Beall Jr AC, Jordan Jr GL, De Bakey ME. Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epidemiologic evolution 1958 to 1987. Ann Surg 1989; 209 (06) 698-705 , discussion 706–707
• 28 Kataoka Y, Maekawa K, Nishimaki H, Yamamoto S, Soma K. Iliac vein injuries in hemodynamically unstable patients with pelvic fracture caused by blunt trauma. J Trauma 2005; 58 (04) 704-708 , discussion 708–710
• 29 Smeets RR, Demir D, van Laanen J, Schurink GWH, Mees BME. Use of covered stent grafts as treatment of traumatic venous injury to the inferior vena cava and iliac veins: a systematic review. J Vasc Surg Venous Lymphat Disord 2021; 9 (06) 1577-1587.e1
• 30 Sofue K, Sugimoto K, Mori T, Nakayama S, Yamaguchi M, Sugimura K. Endovascular uncovered Wallstent placement for life-threatening isolated iliac vein injury caused by blunt pelvic trauma. Jpn J Radiol 2012; 30 (08) 680-683
• 31 Tillman BW, Vaccaro PS, Starr JE, Das BM. Use of an endovascular occlusion balloon for control of unremitting venous hemorrhage. J Vasc Surg 2006; 43 (02) 399-400
• 32 Fraga GP, Bansal V, Fortlage D, Coimbra R. A 20-year experience with portal and superior mesenteric venous injuries: has anything changed?. Eur J Vasc Endovasc Surg 2009; 37 (01) 87-91
• 33 Henne-Bruns D, Kremer B, Lloyd DM, Meyer-Pannwitt U. Injuries of the portal vein in patients with blunt abdominal trauma. HPB Surg 1993; 6 (03) 163-168
• 34 Pearl J, Chao A, Kennedy S, Paul B, Rhee P. Traumatic injuries to the portal vein: case study. J Trauma 2004; 56 (04) 779-782
• 35 Reilly PM, Rotondo MF, Carpenter JP, Sherr SA, Schwab CW. Temporary vascular continuity during damage control: intraluminal shunting for proximal superior mesenteric artery injury. J Trauma 1995; 39 (04) 757-760
• 36 Sundarakumar DK, Smith CM, Lopera JE, Kogut M, Suri R. Endovascular interventions for traumatic portal venous hemorrhage complicated by portal hypertension. World J Radiol 2013; 5 (10) 381-385
• 37 Jurkovich GJ, Hoyt DB, Moore FA. et al. Portal triad injuries. J Trauma 1995; 39 (03) 426-434
• 38 Pachter HL, Drager S, Godfrey N, LeFleur R. Traumatic injuries of the portal vein. The role of acute ligation. Ann Surg 1979; 189 (04) 383-385
• 39 Stone HH, Fabian TC, Turkleson ML. Wounds of the portal venous system. World J Surg 1982; 6 (03) 335-341
• 40 Lin B-C, Fang J-F, Wong Y-C, Hwang T-L, Hsu Y-P. Management of cirrhotic patients with blunt abdominal trauma: analysis of risk factor of postoperative death with the Model for End-Stage Liver Disease score. Injury 2012; 43 (09) 1457-1461