Iatrogenic arterial injury is an increasingly important cause of arterial trauma

Giswold, Mary E.; Landry, Gregory J.; Taylor, Lloyd M.; Moneta, Gregory L.

doi:10.1016/j.amjsurg.2004.01.013

Cited by 68 publications

(42 citation statements)

References 4 publications

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“…Iatrogenic injuries accounted for 15-20 % of civilian trauma as seen in the present study [10]. Open procedures accounted for majority of iatrogenic injuries unlike percutaneous vascular interventions in the west [11]. Vascular interventions caused iatrogenic injuries in 5 out of 12 cases.…”

Section: Discussionmentioning

confidence: 85%

Peripheral Arterial Injuries: an Indian Experience

Joshi

2015

Indian J Surg

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Arterial injuries present the most challenging conditions in surgical practice. Many fail to reach the specialist in time and end up losing limbs or lives. Though well addressed elsewhere, it has received less attention in developing countries like India. There is a need to study these injuries from the perspective of countries like India. The aims of the study are to (1) analyze the epidemiology, presentation, and outcomes of arterial injuries operated by the author in Indian settings; (2) identify factors associated with adverse outcomes; and (3) discuss the critical issues with relevance to our country. Retrospective analysis of arterial injuries operated by the author between July 2010 and February 2014 at our institution was performed. Patients with feasibility of revascularization were included and nonviable limbs requiring primary amputations were excluded. Sixty-one patients fulfilled the criteria of which 55 (90.1 %) were males and 6 (9.8 %) females aged between 5 and 70 years. The mean duration of presentation was 21 h. Majority were resultant of road traffic accidents (62.7 %). Among 49 (80.3 %) noniatrogenic injuries, the mechanism was blunt in 46 (93.8 %, n=49) and penetrating in 3 (6.1 %) cases. Iatrogenic injuries were seen in 12 (19.6 %) cases. Lower limbs accounted for 37 (60.6 %) cases, popliteal segment being common, 22 (36 %) cases. Bony injuries were associated in 39 (63.9 %) cases. The most common procedure was interposition graft (49.1 %). Six (9.8 %) patients required an amputation resulting in 55 (90.1 %) salvaged limbs.Reaching a specialist center in appropriate time can result in good limb salvage rates and functional outcomes. Creating awareness and training the personnel are the critical issues in the management of arterial injuries in India.

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Section: Discussionmentioning

confidence: 85%

Peripheral Arterial Injuries: an Indian Experience

Joshi

2015

Indian J Surg

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“…Iatrogenic vascular injury is common, accounting for up to 34% of arterial trauma. 12 However, it is impossible to know if axillary artery pseudoaneurysm is a result of the initial trauma or its treatment. It is possible that the act of reduction contributes to or even causes the vascular insult, as tractional forces are applied across the vessels during manipulation of the limb.…”

Section: Discussionmentioning

confidence: 99%

Delayed brachial plexus compression secondary to anterior shoulder dislocation—The late consequence of an axillary artery pseudoaneurysm: A case report

2006

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“…30-40%) wächst stetig und wird vor allem durch Interventionen als Punktionstraumen, Tumorresektionen und unfallchirurgische bzw. orthopädische Eingriffe an großen Gelenken verursacht [4]. Extremitätenarterien haben einen Anteil von ca.…”

Section: Epidemiologieunclassified

“…Abb 4. 8 Patientin mit stumpfer Grad-II-Verletzung der Arteria axillaris durch eine Humerusluxationsfraktur (Pfeil auf A. axillaris).…”

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Gef��verletzungen an den Extremit�ten

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Sadeghi‐Azandaryani

Mutschler

et al. 2004

Chirurg

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Vascular injuries of the extremities account for most instances of vascular trauma (ca. 70%), and they entail a risk of amputation about 10-20%. According to the kind of force that has acted, arterial trauma is classified as direct or indirect. The scale of hemorrhage and peripheral ischemia depend on the nature and severity of the arterial lesion. In patients with multiple injuries, routine use of Doppler sonography and duplex sonography can facilitate early diagnosis and treatment of vascular injuries. With great certainty, clinical examination and an AB or WB index of >1.0 can rule out the presence of vascular injury that requires treatment. After excluding further life-threatening injuries, surgery should be performed immediately when there is critical ischemia, squirting hemorrhage, or a rapidly expanding hematoma. Angiography or duplex sonography findings determine the further procedure in vascular injuries that do not require immediate treatment. Occlusion of a reconstructed artery, manifestation of a compartment syndrome, and insufficient anticoagulation are the main factors affecting the risk of amputation.

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Iatrogenic arterial injury is an increasingly important cause of arterial trauma

Cited by 68 publications

References 4 publications

Peripheral Arterial Injuries: an Indian Experience

Peripheral Arterial Injuries: an Indian Experience

Delayed brachial plexus compression secondary to anterior shoulder dislocation—The late consequence of an axillary artery pseudoaneurysm: A case report

Gef��verletzungen an den Extremit�ten

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