Vascular trauma in children and adolescents

Navarre, J. Robert; Cardillo, Peter J.; Gorman, James; Clark, Paul; Martinez, Bernardo D.

doi:10.1016/0002-9610(82)90075-7

Cited by 24 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Há cinco grandes séries relatadas na literatura descrevendo trauma vascular cirúrgico pediátrico. Coletivamente, elas apresentam 204 casos em um período acima de 61 anos, ou seja, uma média de 3,3 por ano [6][7][8][9][10][11] . O calibre dos vasos, a forte tendência ao vasoespamo e a baixa resistência à isquemia são os principais fatores limitantes ao bom resultado do tratamento cirúrgico.…”

Section: Introductionunclassified

Trauma vascular na população pediátrica

et al. 2012

View full text Add to dashboard Cite

ResumoContexto: O trauma vascular na população pediátrica apresenta-se como um desafio único, frente à sua incidência relativamente baixa, mesmo em centros médicos de referência. Devido à fragilidade dos tecidos, ao reduzido tamanho dos vasos e à sua baixa incidência, manifesta-se com taxas significativas de morbidade e mortalidade. Objetivo: Descrever e analisar os casos de trauma vascular em pacientes pediátricos admitidos em hospital terciário. Métodos: Por meio de estudo retrospectivo, analisaram-se os casos de trauma vascular em pacientes menores de 18 anos, admitidos de janeiro de 2000 a julho de 2010, levando-se em conta dados demográficos, mecanismos de lesão, traumas associados, tratamentos empregados e complicações. Resultados: Foram estudados 242 pacientes com trauma vascular, sendo 37 (15,2%) pertencentes à população pediátrica. A média de idade foi de 12,5 anos, sendo 81% dos participantes da pesquisa do sexo masculino. Entre os mecanismos de lesão, o trauma penetrante foi o mais comum (57%), seguido do contuso (38%) e do iatrogênico (5%). Das técnicas cirúrgicas empregadas, o enxerto arterial com veia autóloga foi o procedimento mais comum (13 casos). Houve um caso de amputação primária (infrapatelar) e quatro amputações no período pós-operatório precoce (três transfemorais e uma transtársica). Dos 11 pacientes admitidos com lesão de artéria poplítea, a taxa de amputação transfemoral pós-operatória foi de 27,3%. Houve apenas um óbito devido a trauma iatrogênico em lactente hemofílico. Conclusões: O trauma vascular pediátrico envolve vários desafios técnicos, como o vasoespasmo e o calibre dos vasos. As altas taxas de amputações observadas em pacientes com lesões de artéria poplítea, apesar das tentativas de revascularização, reforçam a gravidade desse tipo de trauma.Palavras-chave: vasos sanguíneos; lesões do sistema vascular; traumatismos da perna; criança; adolescente; amputação traumática. AbstractBackground: Vascular trauma in the pediatric population is a unique challenge, mainly due to its relatively low incidence, even in high complexity medical centers. Due to the fragility of the tissues, the small size of vessels and low incidence, it manifests with significant rates of morbidity and mortality.Objective: To describe and analyze the cases of vascular trauma in pediatric patients admitted to a tertiary hospital. Methods: Through retrospective study we analyzed the cases of vascular trauma in patients younger than 18 years, admitted from January 2000 to July 2010, taking into account demographic data, mechanisms of injury, associated injuries, treatment techniques and complications. Results: During the studied period, 242 patients were admitted with vascular trauma, 37 (15.2%) belonging to the pediatric population. The average age was 12.5 years, and 81% of the research participants were male. Related to the mechanisms of injury, penetrating trauma was the most common (57%), followed by blunt (38%) and iatrogenic (5%). Among the surgical techniques employed, arterial bypass with autologous v...

show abstract

Section: Introductionunclassified

Trauma vascular na população pediátrica

et al. 2012

View full text Add to dashboard Cite

show abstract

“…5 Blunt trauma around the knee joint is notorious for missed vascular injury, potentially leading to a nonfunctioning limb or amputation. 5,12 Two of our 3 patients with blunt trauma to the popliteal region did experience significant limb ischemia as a results of a delay in diagnosis. An aggressive attempt to salvage a limb in one of these patients was successful but with persistent nerve damage and muscle loss.…”

Section: Discussionmentioning

confidence: 81%

“…Iatrogenic injuries are most common during the first 2 years of life, with vascular injuries in older children and adolescents being penetrating in nature, and up to 38% of cases in the young or middle-aged child caused by blunt truama. [5][6][7][8][9][10][11][12][13] In particular, lower extremity arterial injury accounts for only 30% of the reported pediatric vascular trauma cases; however, blunt injuries appear to be concentrated in the lower limbs. 5 Seventy percent of blunt-impact vascular trauma is reported to occur in the lower extremity.…”

Section: Discussionmentioning

confidence: 99%

Open surgical repair of children less than 13 years old with lower extremity vascular injury

Dalsing

Cikrit

Sawchuk

2005

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…8 Iatrogenic vascular injuries are more common in the infant population, while older children and adolescent will experience penetrating injuries. [9][10][11] Common causes for infant vascular injuries are cardiac catheterizations and arterial blood pressure monitoring devices. 11 "Soft signs" of vascular injury are difficult to evaluate on this population age due to lack of verbalization of pain and diminished or absent sensation.…”

Section: Discussionmentioning

confidence: 99%

Evidence for nonoperative management of acute limb ischemia in infants

Matos

Fajardo

Dalsing

et al. 2012

Journal of Vascular Surgery

View full text Add to dashboard Cite

Acute limb ischemia (ALI) in infants is a catastrophic event. We performed a query of our database to determine those with ALI. Twelve patients were identified. The most frequent presentation was cyanotic limbs. Eleven patients were treated nonoperatively with anticoagulation. One patient was treated surgically with Fogarty balloon thrombectomy. There were three deaths all due to associated comorbidities. All had viable limbs on follow-up examination. There were three complications in the patients managed conservatively. Our recommendation for infants presenting with ALI is conservative observation with anticoagulation and intervention only for cases with tissue loss.

show abstract

Vascular trauma in children and adolescents

Cited by 24 publications

References 3 publications

Trauma vascular na população pediátrica

Trauma vascular na população pediátrica

Open surgical repair of children less than 13 years old with lower extremity vascular injury

Evidence for nonoperative management of acute limb ischemia in infants

Contact Info

Product

Resources

About