Vascular Trauma: New Directions in Screening, Diagnosis and Management

Kobayashi, Leslie; Coimbra, Raúl

doi:10.5772/26467

Cited by 2 publications

(3 citation statements)

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“…Clinical signs following aortic injury can be unreliable, and delays in recognition and management is associated with greater mortality and a longer hospital stay (21,22). Thus, individuals with MVT who are injured in rural areas often have a less favorable outcome than urban residents (3,23,24).…”

Section: Discussionmentioning

confidence: 99%

“…For the 21 patients who were admitted alive, 14 underwent open surgery within 24 h of admissionmost often laparotomy or thoracotomy. The golden standard for management of all vascular injury over the past 50 years has been open surgery with primary repair, vein patch, and interposition or bypass grafting (21). This strategy has been challenged by rapid developments in the fields of imaging technology and endovascular treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Three patients in our study had endovascular stent graft insertion within the first 24 h after admission. However, patients with haemorrhagic shock and classical signs of arterial injury should still be taken immediately to open surgery (21,30). In a modern setting, MVT can be treated with open and endovascular technology in a hybrid OR.…”

Section: Discussionmentioning

confidence: 99%

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High Mortality from Major Vascular Trauma in Traffic Accidents: A Population-Based Study

et al. 2019

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Background and Aims: Injuries involving major arteries are an important cause of mortality and morbidity, most often from road traffic accidents. Our aim was to study the outcome of major vascular trauma from traffic accidents in an entire population, including patients who die at the scene and those who reach hospital alive. Materials and Methods: This was a retrospective analysis of all patients who sustained major vascular trauma in traffic accidents in Iceland from 2000 to 2011. Patient demographics, mechanism, and location of vascular injury and treatment were registered. Injury scores were calculated and overall survival estimated. Results: There were 62 individuals (mean age 44 years, 79% males) with 95 major vascular traumas, giving an incidence of 1.69/100,000 inhabitants (95% confidence interval: 1.27–2.21). A total of 33 died at the scene and 8 during transportation to hospital but 21 (34%) reached hospital alive. Most patients who succumbed had thoracic major vascular traumas (76%) or abdominal major vascular traumas (23%). Mean new injury severity score for the 21 admitted patients was 44. A total of 18 were operated with vascular repair, 3 with endovascular stent graft insertion. The mean hospital stay for discharged patients was 34 days. Altogether, 15 of the 62 patients (24%) survived to discharge from hospital, with a 5-year survival of 86% for discharged patients. Conclusion: Every other patient with major vascular trauma following traffic accidents died at the scene and a further 13% died during transportation to hospital, most of whom sustained major vascular trauma to the thoracic aorta. However, one-third of the patients reached hospital alive and 71% of them survived to discharge, with excellent long-term survival.

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