On Sunday, September 27, 4:15–5:45 pm in Room 147AB, "The Management of Traumatic Great Vessel Injuries" (PS122) will tackle a significant shift in surgical care: the growing use of endovascular techniques for traumatic injuries to the aorta, pulmonary trunk, pulmonary veins, and venae cavae.
“This session was designed to talk about an area that has evolved tremendously in the management of vascular trauma of the chest,” explained moderator Erika L. Mitchell, MD, MEd SE, FACS, chief of vascular and endovascular surgery at Regional One Health Elvis Presley Trauma Center in Memphis, Tennessee. “A significant number of cases are now being managed with an endovascular approach—I'd say about 40% to 60%.”
Her co-moderator, Joseph J. DuBose, MD, FACS, a professor in the Department of Cardiovascular and Thoracic Surgery and the Department of Surgery and Perioperative Care at The University of Texas at Austin Dell Medical School, agreed. “Endovascular technologies have really changed the game and brought an entirely new approach to these injuries that needs to be examined carefully. In many ways, that has already replaced traditional open repairs.”
Dr. Mitchell said their complementary backgrounds will bring different perspectives to the discussion: “Dr. DuBose was a trauma surgeon before he was a vascular surgeon, and I'm a vascular surgeon who does vascular trauma, so we look at things with a slightly different lens.”
The session also is intended to engage the full range of surgeons who may treat these injuries, Dr. DuBose said.
“It's not just vascular surgeons talking to ourselves,” he said. “It’s important that the stakeholders involved in the care of these patients, both trauma and vascular surgeons, understand the potential and limitations of endovascular technologies as they're emerging. That is going to be paramount to moving forward and making the best selection for our patients.”
Presenters include vascular and trauma surgeons from across the US. They will present endovascular options for managing blunt thoracic aortic injury, great vessel injuries, and non-great vessel bleeding, as well as management strategies for cases in which endovascular approaches are not an option.
Their presentations will give attendees a comprehensive overview of how these evolving approaches can reduce complications and morbidity and shorten recovery time, as well as how and when to use specific techniques. Dr. Mitchell said the session also will leave room for discussion: “There's going to be some conversation and debate about the best treatment modality for some of these conditions.”
The moderators also hope the discussion will encourage team-based approaches to trauma care. Dr. DuBose explained, “My hope is that we can broaden the perspectives of all stakeholders and start to come to some kind of consensus on what would be the ideal pathway for defining optimal care and moving forward. That may include expanding skill sets or building greater collaboration between the stakeholders when it comes to vascular injury patients.”
The discussion will extend beyond the panel, with attendees encouraged to take part. “I think the more perspectives, the better, especially when we're talking about introducing new technologies into a well-appreciated trauma pathology,” said Dr. DuBose.
