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Eur J Cardiothorac Surg 2005;28:906-908
© 2005 Elsevier Science NL

Case report

Emergency endovascular repair for traumatic injury of the inferior vena cava

Vascular Surgery-Department of Surgery, University of Insubria, Ospedale di Circolo, viale Borri 57, 21100 Varese, Italy

Received 2 June 2005; received in revised form 5 September 2005; accepted 6 September 2005.

^_* Corresponding author. Tel.: +39 0332 278226; fax: +39 0332 260260. (Email: gabriele.piffaretti{at}tiscali.it).

Conventional open repair of the traumatic injuries of the inferior vena cava still represents a surgical challenge, since it carries high morbidity and mortality rates close to 100% in emergency setting. Surgical techniques required the total mobilization of the liver in the former case and the anatomic exposure of the aorto-iliac bifurcation in the latter. We report a case of uncontrolled hemorrhage from the inferior vena cava, managed by endovascular technique. A 65-year-old woman underwent endovascular stent-grafting for traumatic injury of the inferior vena cava. We performed the endovascular approach as we similarly did for aortic repair using a simple groin access through the common femoral vein; no additional dissection of the inferior vena cava or adjacent structures was needed using endovascular approach, thus avoiding additional operative trauma, and time with the stent-graft procedure was 9 min. Inferior vena cava stent-grafting without laparotomy and retroperitoneal dissection is feasible and could be a very attractive alternative to open surgery for rupture of the vena cava.

Key Words: Inferior vena cava • Endovascular repair • Stent-graft • Intraoperative injury • Blunt trauma

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