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Editorial
. 2025 Jan 15;11(2):101725.
doi: 10.1016/j.jvscit.2025.101725. eCollection 2025 Apr.

The use of stent grafts for management of junctional vascular injuries: Is this accepted practice?

Ilenia D'Alessio  1 , Valerio Tolva  1 , Ailin Belloni  2 , Sandro Lepidi  3 , Mario D'Oria  3
Affiliations
Editorial

The use of stent grafts for management of junctional vascular injuries: Is this accepted practice?

Ilenia D'Alessio et al. J Vasc Surg Cases Innov Tech. .
No abstract available

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Conflict of interest statement

None.

Figures

Fig 1
Fig 1
Preoperative computed tomography angiography (CTA) of a 84-year old male patient with iatrogenic injury of the right subclavian artery (SA) from misplacement of a central line. (Informed consent provided by the patients for publication of anonymized figure).
Fig 2
Fig 2
Same patient as Fig 1. Schematic representation of the subclavian injury and main anatomical landmarks. (Informed consent provided by the patients for publication of anonymized figure).
Fig 3
Fig 3
Same patient as Fig 1. Final angiography showing full patency of the right subclavian artery (SA) and absence of visible bleeding after placement of a VBX stent graft (W. L. Gore & Associates). The stent was deployed in retrograde fashion through a right brachial cutdown. The vertebral artery (VA) (nondominant) was covered; the patient did not develop any neurological sequelae and was alive with palpable radial pulse at 6-month follow-up. (Informed consent provided by the patients for publication of anonymized figure).
Fig 4
Fig 4
Intraoperative details. A 43-year-old woman who sustained a motor vehicle accident and developed a contained traumatic rupture of the brachiocephalic trunk (BCT) with associated periaortic hematoma. The BCT was stented with a VBX stent graft (W. L. Gore & Associates) that was distally landed in the common carotid artery. The stent was deployed in retrograde fashion through a right carotid cutdown. The proximal right subclavian artery (SA) was embolized with a Microvascular Plug (Medtronic). (Informed consent provided by the patients for publication of anonymized figure).
Fig 5
Fig 5
Same patient as Fig 4. Comparison of preoperative vs postoperative computed tomography angiography (CTA) at 24 and 72 hours showing complete resolution of the periaortic hematoma. (Informed consent provided by the patients for publication of anonymized figure).
Fig 6
Fig 6
Same patient as Fig 4. Three-dimensional volume rendering of computed tomography angiography (CTA) follow-up at 1 year after surgery showing preserved patency of the stent graft. The patient did not develop any neurological sequelae and had mild claudication of the right arm for which received carotid-subclavian bypass. (Informed consent provided by the patients for publication of anonymized figure).
See this image and copyright information in PMC

References

    1. Goodenough C.J., Cobb T.A., Holcomb J.B. Use of REBOA to stabilize in-hospital iatrogenic intra-abdominal hemorrhage. Trauma Surg Acute Care Open. 2018;3 - PMC - PubMed
    1. Chopra A., Modrall G.J., Knowles M., Phelan H., Valentine J.R., Chung J. Uncertain patency of covered stents placed for traumatic axillosubclavian artery injury. J Am Coll Surg. 2016;223:174–183. - PubMed
    1. Carrick M.M., Morrison C.A., Pham H.Q., et al. Modern management of traumatic subclavian artery injuries: a single institution's experience in the evolution of endovascular repair. Am J Surg. 2010;199:28–34. - PubMed
    1. Lin P.H., Koffron A.J., Guske P.J., et al. Penetrating injuries of the subclavian artery. Am J Surg. 2003;185:580–584. - PubMed
    1. Branco B.C., Boutrous M.L., DuBose J.J., et al. Outcome comparison between open and endovascular management of axillosubclavian arterial injuries. J Vasc Surg. 2016;63:702–709. - PubMed

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