The experience of using stent-grafts in the treatment of consequences of traumatic injuries of main arteries of different localization (ruptures, aneurysms, arteriovenous connections)

Objective – to analyze the results of endovascular treatment of patients with traumatic injuries of main arteries of various localization and their consequences (arteriovenous connections (AVS), pseudoaneurysms (PA)) using the technique of stent-graft implantation in the arterial damage area.Materials and methods. An analysis of the treatment in the period 2015‒2025 in SO «Scientific-Practical Center of Endovascular Neuroradiology NAMS of Ukraine» 17 patients (14 (82.3%) men and 3 (17.7%) women) with ruptures, arteriovenous connections, and aneurysms caused by traumatic lesions of main arteries of various locations (6 patients with AVS, 8 with PA, 1 patient with a combination of AVS and PA, 2 patients with arterial rupture and internal bleeding) was performed. The age of the patients ranged from 11 to 70 years (the average age ‒ (38.2 ± 6.2) years). Pathology localization: abdominal cavity – 3, upper limb – 2, lower limb – 4, head and neck – 8. Bullet, shrapnel damage to the artery occurred in 3 patients, stab-cut injury to the artery – in 6, the result of blunt trauma – in 4, iatrogenic nature of the main artery injury occurred – in 4 patients. All patients underwent closure of the site of traumatic arterial damage with the help of stent-graft implantation.Results. The treatment with the use of stent-grafts was technically successful in all cases (100 %). The observation period ranged from 6 months to 10 years, the average observation period ‒ (4.2 ± 0.98) years. Three patients underwent thrombectomy from the aneurysm cavity after stent graft placement. No case of stent-graft thrombosis or disease recurrence was found.Conclusions. The results of the use of stent-grafts in the treatment of patients with traumatic lesions of main arteries and their consequences (AVS, PA) of various localizations indicate the high efficiency and safety of the use of this technology. The advantage of the stent-graft endoprosthesis method is: the smaller size of the surgical trauma, the absence of the risk of general anesthesia, the shorter duration of the patient’s stay in the hospital. The use of the stent-graft endoprosthesis method can act as an independent, minimally traumatic method of treating ruptures of main arteries, AVS, pseudoaneurysms localized in hard-to-reach anatomical areas, an alternative to classical surgical treatment. The use of X-ray endovascular methods allows to improve the results of treatment of patients with traumatic damage to main arteries, post-traumatic AVS and PA of various localizations.