Endovascular Treatment for Abdominal Vascular Injury：Six Factors to Consider in Deciding Between Coil Embolization and the VIABAHN Endoprosthesis

Abstract

Both the VIABAHN^Ⓡ endoprosthesis and coil embolization have been used for the treatment of visceral arterial injuries. In coil embolization, the blood flow through the treated vessel is interrupted, whereas with VIABAHN^Ⓡ, the blood flow in the treated vessel can be potentially preserved. However, not all abdominal vascular injuries that can be treated by coil embolization are suitable indications for the use of VIABAHN^Ⓡ. In this paper, we propose six considerations for selecting the most appropriate endovascular treatment method for vascular injuries: 1) the diameter of the injured vessel; 2) the risk of organ ischemia associated with embolization; 3) the access route to the injury; 4) the availability of VIABAHN^Ⓡ at the facility; 5) the cost and time required for the procedure; and 6) the risk of occlusion of VIABAHN^Ⓡ. In determining the treatment method for vascular injuries, it is essential to evaluate uncertain and quantitatively challenging factors related to the patient, physician, and the facility. Therefore, it is crucial to reflect on the clinical course of each case and discuss the most appropriate choice of treatment method.