Journal of Vascular Medicine & Surgery

Abstract

Use of a Hybrid Open and Endovascular Approach to Successfully Repair a Traumatic Retrohepatic Inferior Vena Cava Injury

Yan Shi, Matthew J Wall Jr and Ramyar Gilani

Purpose: To describe a damage control open and endovascular approach that successfully repaired a catastrophic retrohepatic injury to the inferior vena cava (IVC).
Case Report: A 25-year-old man presented with two gunshot wounds to the trunk. During open operative exploration, a penetrating injury to the IVC behind the caudate lobe of the liver was encountered. To quickly control hemorrhage, en-mass ligation of the injured area and surrounding tissues was performed which resulted in significant IVC stenosis at the level of the repair. After resuscitation in the intensive care unit, the patient was brought back to the operating room where inline flow through the IVC was reestablished by bridging the defect using a 20mm x 55mm covered stent graft.
Conclusions: As endovascular expertise and devices become more refined and readily available to treat trauma, variations of this hybrid technique have the potential to become powerful tools to repair retrohepatic IVC injuries.