Bernardino C. Branco, MD, Joseph J. DuBose, MD, Luke X

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Presentation transcript:

Trends and outcomes of endovascular therapy in the management of civilian vascular injuries Bernardino C. Branco, MD, Joseph J. DuBose, MD, Luke X. Zhan, MD, PhD, John D. Hughes, MD, Kay R. Goshima, MD, Peter Rhee, MD, Joseph L. Mills, MD Journal of Vascular Surgery Volume 60, Issue 5, Pages 1297-1307.e1 (November 2014) DOI: 10.1016/j.jvs.2014.05.028 Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 1 Study outline. A total of 842 patients (1.9%) who sustained arterial injuries underwent hybrid (open and endovascular) procedures. NOM, Nonoperative management. NTDB, National Trauma Data Bank. Journal of Vascular Surgery 2014 60, 1297-1307.e1DOI: (10.1016/j.jvs.2014.05.028) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 2 Management trends throughout the study period. There was a significant increase in endovascular management during 9 years (P < .001). A significant decrease was noted for the open and nonoperative management (NOM) groups (P < .001). Mortality significantly decreased during the study period (P < .001). n, Number of patients per study year. ∗Standard error exceeds 10%. Journal of Vascular Surgery 2014 60, 1297-1307.e1DOI: (10.1016/j.jvs.2014.05.028) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 3 Management trends throughout the study period according to injury mechanism. For blunt trauma, there was a significant increase in endovascular management and a decrease in open procedures during 9 years (P < .001). No difference was noted in the nonoperative management (NOM) group (P = .056). Mortality for blunt trauma decreased significantly during the study period (P < .001). For penetrating trauma, there was a statistically significant but not clinically relevant increase in endovascular procedures (P < .001). Nonoperative management decreased during the study period (P < .001), and no significant change was noted for the open group (P = .089). Mortality for penetrating trauma decreased significantly during the study period (P < .001). n, Number of patients per study year. *Standard error exceeds 10%. Journal of Vascular Surgery 2014 60, 1297-1307.e1DOI: (10.1016/j.jvs.2014.05.028) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 4 Growth in endovascular procedures during the study period according to the type of arterial injury. Statistically significant growth was achieved for all injuries (P < .001). Journal of Vascular Surgery 2014 60, 1297-1307.e1DOI: (10.1016/j.jvs.2014.05.028) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 5 Management according to Injury Severity Score (ISS). n, Number of patients; NOM, nonoperative management. Journal of Vascular Surgery 2014 60, 1297-1307.e1DOI: (10.1016/j.jvs.2014.05.028) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 6 Time to event analysis for mortality. HLOS, Hospital length of stay. Survival curves with 95% confidence intervals. Journal of Vascular Surgery 2014 60, 1297-1307.e1DOI: (10.1016/j.jvs.2014.05.028) Copyright © 2014 Society for Vascular Surgery Terms and Conditions