ASSA14-12-10 Mobile minimally invasive interventional shelter: A new answer to pre-hospital care of large arterial trauma

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Abstract

Objective

Disasters often lead to heavy casualties, in which vascular injury, especially large arterial trauma, is one of the primary factors causing immediate death. Although minimally invasive intervention in diagnosing and treating traumatic vascular injuries has achieved good effects, it has not been available at the disaster sites in any country for the lack of catheterization labs on-spot. The present study was to evaluate whether the mobile minimally invasive interventional shelter (MIS), which was a new pre-hospital treatment vehicle-mounted system we developed, was competent to perform emergency interventions on large arterial trauma pre-hospital under the special conditions, such as disaster.

Methods

At first, the MIS was unfold in the site outside hospital. And then, ten large animal models of abdomens aorta or femoral arterial trauma were created (5 in each) accurately with the help of a new developed medium vehicle-mounted digital subtraction angiography (DSA) machine in shelter. Endovascular stent-graft exclusion was performed following the established convention of rapid intervention therapy. The treatment capacity of the shelter was evaluated on the basis of data on image clarity, use stability, surgery duration and clinical results.

Results and Disscussion

The image clarity and operation stability of the vehicle-mounted DSA machine directly relates to the efficiency and success rate of interventional treatment in MIS. It was indicated that the DSA machine in MIS showed good imaging performance and the operation of all equipments and devices were stable in interventional procedures. The endovascular stent-graft exclusions were performed successfully in the MIS. The average operation time for treating abdomens aorta and femoral arterial trauma was x ± x min and x ± x min, respectively. And no operation related complication was found after operations. The two-week survival rate in all animal models of abdomens aorta injury and femoral arterial injury was 100%.

Conclusion

The MIS could work properly under the field conditions and make it possible to perform endovascular stent-graft exclusion on abdomens aorta or femoral arterial trauma outside hospital. So, the MIS should have the potential to efficiently treat fatal vascular injuries on-spot and save lives of patients who used to die rapidly due to haemorrhagic shock and lack of effective treatment device and approach after disaster.

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