Arterial trauma of the limbs and pelvis: A 6-year experience of an urban trauma centre

Galyfos, George; Giannakakis, Sotiris; Geropapas, Georgios; Kastrisios, Georgios; Stefanidis, Giannis; Stamatatos, Ioannis; Kerasidis, Stavros; Papacharalampous, Gerasimos; Maltezos, Chrisostomos

doi:10.1007/s13126-015-0215-4

Cited by 2 publications

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References 28 publications

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“…18 In a recent report from a level I trauma center, we found a 22% incidence of iatrogenic trauma among patients presenting with vascular trauma of the extremities. 19 However, the majority of iatrogenic cases in that study were associated with orthopedic surgery in contrast to the current report referring to abdominal and pelvic trauma due to other types of surgery. Although major retroperitoneal vascular injury is quite rare during laparoscopic procedures with an incidence lower than 1%, it seems that the risk increases dramatically when the experience of the surgeon is low.…”

Section: Discussioncontrasting

confidence: 70%

Iatrogenic Vascular Injuries of the Abdomen and Pelvis: The Experience at a Hellenic University Hospital

Filis

Sigala

Triantafyllou

et al. 2019

Vasc Endovascular Surg

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Background: The aim of this study is to present the experience of a Vascular Division at a Hellenic University hospital concerning the management of iatrogenic vascular injuries (IVIs) of the abdomen or pelvis. Patients and Methods: This is a retrospective study evaluating all IVIs reported during a 10-year period in our institution. Only injuries warranting a vascular surgeon consultation were included in the study. Non-iatrogenic injuries were not included. Mortality and major complications within 30 days were evaluated. Results: Overall, 70 cases were recorded, with 41% being venous and 59% being arterial injuries. Iliac arteries (51%) were the most common location and rupture/lacerations (73%) were the most common type of injury. General surgery (61.5%) and cardiology (30%) procedures were the most frequently involved procedures. A 30-day mortality was 5.7%, with 30% of cases treated conservatively. Synthetic bypass grafting (odds ratio [OR] = 65.0; 95% confidence interval [CI], 4.022-1050.358; P = .003) and male gender (OR = 83.77; 95% CI, 4.040-1736.738; P = .004) were associated with death. Conclusions: Iatrogenic vascular injuries of the abdomen or pelvis are usually associated with general surgery and endovascular procedures. When vascular consultation is requested early, mortality could remain low. However, a selected number of stable patients with retroperitoneal or pelvic hematomas could be treated conservatively, yielding satisfying results.

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Section: Discussioncontrasting

confidence: 70%

Iatrogenic Vascular Injuries of the Abdomen and Pelvis: The Experience at a Hellenic University Hospital

Filis

Sigala

Triantafyllou

et al. 2019

Vasc Endovascular Surg

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“…The incidence of iatrogenic vascular injuries (IVIs) has been increased during the last decades, mainly due to the growing number of percutaneous coronary interventions (PCIs). [1][2][3] Although fatality seems to be higher among such cases compared to noniatrogenic vascular trauma, 4 almost half of the injuries have been considered avoidable. 5 Prompt diagnosis and management are critical for the patients' course, while any necessary vascular surgical reconstruction could further increase mortality in the critically ill group of cardiac patients.…”

Section: Introductionmentioning

confidence: 99%

Vascular complications during transcatheter aortic valve implantation: The role of the vascular surgeon

et al. 2020

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Introduction This study compares the incidence of vascular complications and other major outcomes between patients undergoing transcatheter aortic valve implantation, with and without a standardized preoperative vascular surgeon consultation. Methods This retrospective study evaluated all patients scheduled for transcatheter aortic valve implantation during a five-year period at a Hellenic University Hospital. Two main periods were evaluated: Group A (early period (2014–2015), without a standardized preoperative vascular surgeon consultation) and Group B (late period (2016–2018), with a standardized preoperative vascular surgeon consultation). All vascular complications as well as other major outcomes (early death, stroke, myocardial infarction, and treatment) were recorded. Univariate and multivariate analyses were also conducted. Results Overall, 382 transcatheter aortic valve implantation procedures were conducted (Group A: n = 115; duration = 19 months; Group B: n = 267; duration = 41 months). Overall, 58 vascular complications were recorded (21 patients in Group A and 37 patients in Group B (18.3% versus 13.9%; P = 0.279)). However, vascular complications that necessitated a vascular surgeon’s interference were more frequent during the first period (13% versus 4.9%; P = 0.009). Among patients with a vascular complication, early mortality was higher during the first period (14.3% versus 0%; P = 0.034) although stroke and myocardial infarction rates were similar. Age >80 years (OR = 1.856 [1.134–3.452]; P = 0.03) and preoperative vascular surgeon consultation (OR = 0.345 [0.132–0.756]; P = 0.015) were the only independent predictors for vascular complications. Conclusions A standardized preoperative evaluation by a vascular surgeon may decrease the risk for vascular complications that necessitate a repair as well as early mortality among patients undergoing transcatheter aortic valve implantation procedures.

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Arterial trauma of the limbs and pelvis: A 6-year experience of an urban trauma centre

Cited by 2 publications

References 28 publications

Iatrogenic Vascular Injuries of the Abdomen and Pelvis: The Experience at a Hellenic University Hospital

Iatrogenic Vascular Injuries of the Abdomen and Pelvis: The Experience at a Hellenic University Hospital

Vascular complications during transcatheter aortic valve implantation: The role of the vascular surgeon

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