“Hit below the Waist”: A Primer for Trainees and Interventional Radiologists Managing Lower Extremity Vascular Trauma

Monday, March 6, 2023

5:10 PM – 5:15 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Krishna Kinariwala, MD

Interventional Radiology Resident
Temple University Hospital

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Ekramul Gofur, MD

Radiology Resident
Westchester Medical Center
DK

Daniel Kushner, MD

Radiology Resident
Temple University Hospital
JP

Joseph Panaro, MD

Clinical Associate Professor, Interventional Radiology
Temple University Hospital
SL

Shane Lee, MD

Interventional Radiology Attending
Temple University Health System
GC

Gary Cohen, MD

Chair, Department of Radiology
Temple University Hospital
PG

Perry Gerard, MD MBA FACR

Professor, Diagnostic Radiology
Westchester Medical Center
JM

Jared Meshekow, MD MPH

Clinical Assistant Professor, Vascular and Interventional Radiology
Temple University Hospital

Disclosure(s):

Krishna Kinariwala, MD: No financial relationships to disclose

Ekramul Gofur, MD: No financial relationships to disclose

Learning Objectives:

1. To classify common vascular injuries encountered in blunt and penetrating lower extremity trauma.

2. To outline endovascular and open treatment options for vascular trauma to the lower extremity.

3. To provide interprofessional team strategies for improving care and outcomes in patients with lower extremity vascular extremity trauma.

Background:

Lower extremity vascular injury in trauma patients is rare, but can cause significant morbidity and mortality if not treated promptly. Injuries to the vascular system of the lower extremity may be caused by three forms: blunt, penetrating, or a combination of the two. Historically, vascular injuries have been treated with open surgery because of the morbidity and mortality associated with them. Considering growing endovascular techniques, patients who have sustained lower extremity trauma may not be required to undergo operative treatment if they are appropriate candidates for endovascular treatment. Both the Western Trauma Association (WTA) and the Eastern Association for the Surgery of Trauma (EAST) provide recommendations on the management of vascular injuries. It is important to note that some vascular injuries are more appropriate for endovascular interventions while others are more suitable for surgical repair. With this exhibit, trainees and interventional radiologists will learn how to effectively manage lower extremity trauma and how to determine whether a patient is a candidate for endovascular repair.

Clinical Findings/Procedure Details:

I. Overview of mechanisms of injury of the lower extremity that may result in vascular injuries.

II. Review of WTA and EAST Classifications of Vascular Injury and management recommendations.

III. Endovascular techniques for the treatment of lower extremity posttraumatic vascular injury.

IV. Interprofessional team strategies to improve care and outcomes for patients with vascular extremity trauma to the lower extremities.

Conclusion and/or Teaching Points:

Interventional radiologists will continue to play an important and increasing role as endovascular treatments become more accepted in the interdisciplinary treatment paradigm for lower extremity vascular injury.