Emergency endovascular repair for traumatic injury of the inferior vena cava☆

Abstract

Conventional open repair of the traumatic injuries of the inferior vena cava still represents a surgical challenge, since it carries high morbidity and mortality rates close to 100% in emergency setting. Surgical techniques required the total mobilization of the liver in the former case and the anatomic exposure of the aorto-iliac bifurcation in the latter. We report a case of uncontrolled hemorrhage from the inferior vena cava, managed by endovascular technique. A 65-year-old woman underwent endovascular stent-grafting for traumatic injury of the inferior vena cava. We performed the endovascular approach as we similarly did for aortic repair using a simple groin access through the common femoral vein; no additional dissection of the inferior vena cava or adjacent structures was needed using endovascular approach, thus avoiding additional operative trauma, and time with the stent-graft procedure was 9 min. Inferior vena cava stent-grafting without laparotomy and retroperitoneal dissection is feasible and could be a very attractive alternative to open surgery for rupture of the vena cava.