This WSES position paper provides expert consensus and evidence-based recommendations for the surgical management of acute vascular trauma and emergencies.
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May guide vascular trauma management; extends expert consensus but leaves open the need for prospective validation.
Trauma, both blunt and penetrating, is extremely common worldwide, as trauma to major vessels. The management of these patients requires specialized surgical skills and techniques of the trauma surgeon. Furthermore few other surgical emergencies require immediate diagnosis and treatment like a ruptured abdominal aortic aneurysm (rAAA). Mortality of patients with a rAAA reaches 85 %, with more than half dying before reaching the hospital. These are acute events demanding immediate intervention to save life and limb and precluding any attempt at transfer or referral. It is the purpose of this position paper to discuss neck, chest, extremities and abdominal trauma, bringing to light recent evidence based data as well as expert opinions; besides, in this paper we present a review of the recent literature on rAAA and we discuss the rationale for transfer to referral center, the role of preoperative imaging and the pros and cons of Endoluminal repair of rAAA (REVAR) versus Open Repair (OR).
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Pereira et al. (2015) conducted a review in Vascular trauma and ruptured abdominal aortic aneurysm. Vascular emergency surgery was evaluated. The WSES position paper provides evidence-based guidelines and expert recommendations for the surgical management of neck, chest, extremity, and abdominal vascular trauma.
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