Resuscitative endovascular balloon occlusion of vena cava: An option in managing traumatic vena cava injuries
Traumatic lesions of the inferior vena cava (IVC) account for approximately 25% of abdominal vascular injuries and are among the most challenging and lethal lesions sustained by trauma patients. Whether caused by blunt or penetrating mechanisms of injury, the overall mortality rate is up to 92%; as many as 50% of patients with such injuries die before receiving medical care, and the mortality rate among patients who arrive at the trauma center with signs of life and/or receive operative treatment ranges between 20% and 57% (http://evtoday.com/2013/11/traumatic-ivc-injury-and-repair-the-endovascular-alternative/). During the last few decades, there have been improvement in surgical management of traumatic IVC injury, but results have not been brought up to date. An experimental case series of 13 swine with induced IVC injury has been published by Reynolds et al. (doi:10.1097/TA.0000000000001641) seems to show promising results of IVC balloon occlusion in combination with open surgery. Furthermore, endovascular techniques for the venous system have not developed as widely as those for the arterial segment.