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In this issue of Vascular Rounds Fall 2017, several specialists join together to discuss topics that include Endovascular Therapy for Blunt Aortic Trauma, Shunting in Civilian Extremity Trauma, Pediatric Vascular Trauma, A RESCUE Stent for Non-Compressible Traumatic Hemorrhage, Traumatic Innominate Artery Injury, and Embolization of Arterial Injuries.

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Discuss the causes and treatments for blunt aortic injuries/aortic transection.
  • Explain the challenges in treating pediatric vascular trauma injuries
  • Identify the benefits and challenges in using vascular shunts to treat vascular trauma injuries.

Reading Resources:

  1. Rutherford’s Vascular Surgery Textbook. 8th edition. Elsevier Saunders. Philadelphia, PA 2014 
  2. Demetriades D, Velmahos GC, Scalea TM, et al. Diagnosis and treatment of blunt thoracic aortic injuries: changing perspective. J Trauma 2008; 64: 1415
  3. Azizzadeh A, Kehani K, Miller CC, et al. Blunt traumatic aortic injury; initial experience with endovascular repair. J Vasc Surg 2009; 49: 1403
  4. Subramanian A, Vercruysse G, Dente C, Wyrzykowski A, King E, Feliciano DV. A decade’s experience with temporary intravascular shunts at a civilian level I trauma center. J Trauma (2008) 65(2):316–24; discussion 324–6. doi:10.1097/TA.0b013e31817e5132
  5. Abou Ali AN, Salem KM, Alarcon LH, Bauza G, Pikoulis E, Chaer RA et al. Vascular Shunts in Civilian Trauma. Front Surg. (2017) 4:39. doi:10.3389/fsurg.2017.00039
  6. Tan TW, Joglar FL, Hamburg NM, Eberhardt RT, Shaw PM, Rybin D, et al. Limb outcome and mortality in lower and upper extremity arterial injury: a comparison using the National Trauma Data Bank. Vasc Endovascular Surg (2011) 45(7):592–7. doi:10.1177/1538574411415125
  7. Inaba K, Aksoy H, Seamon MJ, Marks JA, Duchesne J, Schroll R, et al. Multicenter evaluation of temporary intravascular shunt use in vascular trauma. J Trauma Acute Care Surg (2016) 80(3):359–65. doi:10.1097/TA.0000000000000949
  8. Kirkilas M, Notrica D, Langlais C, Muenzer J. Outcomes of arterial vascular trauma in pediatric patients. Journal of Pediatric Surgery. 2016;51:1885-1890.
  9. Leeper CM, Neal MD, McKenna CJ, Gaines BA. Trending Fibrinolytic Dysregulation: Fibrinolysis Shutdown in the Days After Injury Is Associated With Poor Outcome in Severely Injured Children. Annals of Surgery. 2017;3:508-515.
  10. Barquet A, Gelink A, and Giannoudis PV. Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes. Injury. 2015;46(12):2297-313.
  11. Craxford S, Gale M, and Lammin K. Arterial Injury to the Profunda Femoris Artery following Internal Fixation of a Neck of Femur Fracture with a Compression Hip Screw. Case reports in orthopedics. 2013;2013(181293.
  12. Ge PS, Ng G, Ishaque BM, Gelabert H, and de Virgilio C. Iatrogenic pseudoaneurysm of the superior gluteal artery presenting as pelvic mass with foot drop and sciatica: case report and review of literature. Vascular and endovascular surgery. 2010;44(1):64-8.
  13. Roth JS, and Newman EC. Gluteal compartment syndrome and sciatica after bone marrow biopsy: a case report and review of the literature. The American surgeon. 2002;68(9):791-4.
  14. Corbacioglu KS, Aksel G, and Yildiz A. Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report. Turkish journal of emergency medicine. 2016;16(1):26-8.
  15. Griselli F, Calvagna C, Sgorlon G, Zamolo F, D'Oria M, Chiarandini S, and Adovasio R. Management of an Iatrogenic Pseudoaneurysm of the Superior Gluteal Artery by Percutaneous Ultrasound-Guided Thrombin Injection: A Case Report. Annals of vascular surgery. 2017;38(317.e9-.e11.
  16. Spratt JR, Bretzman PA, Lafferty PM, and McGonigal MD. Gluteal Compartment Syndrome: Successful Management with Combined Angioembolization and Surgical Decompression. Minnesota medicine. 2016;99(3):51-2.

Disclosures:

 Drs. Ali, Avgerinos, Mohapatra, Sachdev, Washington, Leers, McEnaney, and Eid have reported no relevant relationships with any entities producing health care goods or services.

Dr. Singh has financial interests with the following any entity or entities producing health care goods or services as indicated below:

  • CE Speakers’ Bureau: Medtronic Venous

Dr. Tillman has financial interests with the following any entity or entities producing health care goods or services as indicated below:

  • Grant/Research Support: Department of Defense

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.com and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 11/2/2017 | Last Modified On: 11/2/2017 | Expires: 11/2/2020

This course has been expired.