Extremities--indications and techniques for treatment of extremity vascular injuries (original) (raw)
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Bulletin of emergency and trauma, 2014
To determine the etiology, signs and symptoms, angiography indications and angiography findings in patients with limb penetrating injuries suspected to have arterial injury. This was a cross-sectional study being performed in Imam Reza Hospital affiliated with Mashhad University of Medical Sciences, Iran between September 2011 and March 2013. We included those patients with extremity blunt and penetrating injuries who were referred for angiography according to standard indications including abnormal distal pulses, complex fracture or dislocation, vascular proximity, fixed hematoma, distal nerve deficit, arterial bruit, thrill and massive soft tissue injuries. During the study period, 148 patients (15 women and 133 men) with a mean age of 31±14.9 (11-82) years were evaluated. The most common cause of injury was motor vehicle accident (127 patients 85%). Angiography indications included abnormal distal pulse examination (124, 83.8%), complex fracture or dislocation (7, 4.7%), near art...
Annals of Vascular Surgery, 1993
Over a 14-month period at Boston City Hospital, 93 consecutive patients who had received a blunt or penetrating extremity injury in proximity to a major vascular structure were evaluated. All patients were totally asymptomatic and underwent arteriography for proximity as a sole indication. Twentyseven patients (27%) were found to have abnormal arteriograms. Muscular branches of the profunda femoris artery were the most frequently injured arteries (28%). Arterial spasm (41%) was the most common radiographic finding. All patients were managed nonoperatively and followed closely by serial pulse examinations. Follow-up arteriography or duplex scanning was used in isolated cases. No patients in this study required operative intervention based on arteriographic findings. No patients have subsequently required operative intervention for delayed arterial abnormalities. Based on these findings we believe the use of arteriography for asymptomatic injuries in proximity to major vascular structures is unwarranted.
Hand (New York, N.Y.), 2008
Computed tomographic angiography (CTA) is a noninvasive modality for evaluating the vascular system and planning treatment strategies. The goal of this study was to validate the clinical utility of CTA in assessment of suspected pediatric extremity traumatic vascular injury, prior to emergent and delayed reconstructive surgery. A retrospective review was performed of all operative patients under 18 years of age who underwent multidetector-row CTA for evaluation of suspected extremity vascular injury. Parameters investigated included age, type of injury, referral source, temporal relationship between the injury and the CTA, CTA findings, operations performed, intraoperative findings, and clinical outcome. Between January 2002 and September 2005, 10 pediatric patients (6 males/4 females; mean age 8 years old, range 3-17) sustained either blunt (N = 8) or penetrating (N = 2) trauma and underwent CTA of the upper (N = 5) or lower extremities (N = 5). A total of 30% (3/10) of patients we...
EXTREMITY VASCULAR INJURIES ? A PROSPECTIVE STUDY.
Introduction: Extremity vascular trauma is common in civilian population following RTA. The aim of this study is to evaluate the results following intervention in extremity vascular trauma cases admitted in Rajiv Gandhi Government General Hospital , Chennai , during period 1st July 2016 to 31st June 2018. Method Of Study: Prospective study Results: Of 94 cases,Commonly injured artery was popliteal artery (31.9%). Most of the cases were treated with interposition vein bypass(88.29%) and remaining with primary repair(6.38%), ligation(4.25%) and thrombectomy (1.06%). Failure following repair was 6.66% . Limb salvage rate was 96.8%. Conclusion: Early intervention with interposition vein bypass with proper technique and proper case selection with adequate fasciotomy and wound care yield better results.
Retrospective assessment of vascular injuries: 23 years of experience
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 2004
To analyze the operation methods, injury etiologies and localizations, post-operative complications and the reasons for mortality in patients who were admitted for peripheral vascular injuries to our clinics. From January 1979 to February 2002, 410 patients were operated for peripheral vascular injuries. Three hundred and one of the patients were male (73.5%) and 109 of them were female (26.5%), and their ages ranged between 1-88 (mean 35.5 years). The most common etiological reason was firearm injuries in 163 patients (39.8%). The most common injured artery was the brachial artery (83 patients, 22.5%) among a total of 369 patients whereas the most commonly injured vein was the common femoral vein (60 patients, 23.4%) in a total of 256 patients. Isolated venous injuries were encountered in 41 patients whereas isolated arterial injuries were detected in 154 patients (37.5%). Hospital admission duration of the patients after trauma was approximately 3 hours. The extremity-salvage rate...
Endovascular treatment for traumatic injuries of the peripheral arteries following blunt trauma
Injury, 2007
Objectives: The continued advances in imaging and stent/stent-graft technology have considerably expanded the indications for endovascular approach also in vascular trauma. We report our institutional experience with endovascular treatment of peripheral arterial injuries after blunt trauma. Methods: Between January 2000 and June 2006 out of a series of 81 patients, 10 male patients (mean age of 50 AE 14 years) with peripheral arterial injuries were managed endovascularly. At admission, haemorrhagic shock was present in three patients. Artery location involved common femoral (n = 2), subclavian (n = 2), axillary (n = 2), external iliac (n = 2), superficial femoral (n = 1), and popliteal (n = 1). Type of lesion was as follows: pseudoaneurysm (n = 4), dissection (n = 4), expanding haematoma (n = 1), and arterio-venous fistula (n = 1). Follow-up program included visit and duplex-ultrasonography, X-rays and/or spiral-computed tomography at 6-month interval during the first year, and yearly thereafter. Results: The lesion was excluded in all cases. All patients survived. Major complications did not occur. Mean hospitalisation was 13 days. Limb-salvage was 100%. Followup ranged from 3 to 60 months (mean 16); a late occlusion of a popliteal stent-graft was managed with another endovascular procedure. Conclusion: In our experience, endovascular treatment of vascular injuries after blunt trauma was feasible and effective. #
The British Journal of Radiology, 2016
Acute vascular injuries are the second most common cause of fatalities in patients with multiple traumatic injuries; thus, prompt identification and management is essential for patient survival. Over the past few years, multidetector CT (MDCT) using dual-phase scanning protocol has become the imaging modality of choice in high-energy deceleration traumas. The objective of this article was to review the role of dual-phase MDCT in the identification and management of acute vascular injuries, particularly in the chest and abdomen following multiple traumatic injuries. In addition, this article will provide examples of MDCT features of acute vascular injuries with correlative surgical and interventional findings.
Imaging of blunt cerebrovascular injuries
European Journal of Radiology, 2006
Arterial dissection, pseudoaneurysm, arteriovenous fistula, arterial laceration and occlusion are uncommon complications of blunt trauma. Angiography has been considered the primary method of evaluation to assess for vascular injuries but, due to the low frequency of these lesions, its screening role has been challenged. Non-invasive imaging, particularly CT angiography (CTA), offers definitive advantages and has emerged as a promising diagnostic screening method. Angiography is shifting to a rather therapeutic role and the endovascular management of these lesions is briefly discussed.