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A decade of civilian vascular trauma in Kosovo.

Jaha L, Andreevska T, Rudari H, Ademi B, Ismaili-Jaha V - World J Emerg Surg (2012)

Bottom Line: The most frequently injured vessel was the superficial femoral artery (25%), followed by the brachial artery (20.9%), crural arteries (13.1%), forearm arteries (14.3%), iliac arteries (7.5%), abdominal aorta (3.3%), common femoral artery (3.3%) and popliteal artery (3.3%).The decision to operate was made based on the presence of "hard signs" of vascular trauma.Injuries to the arteries are associated with significant mortality and morbidity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Vascular Surgery, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo. ljaha@yahoo.com.

ABSTRACT

Purpose: We sought to analyze the results of arterial injury management in a busy metropolitan vascular unit and risk factors associated with mortality and morbidity.

Patients and methods: We analyzed 120 patient with arterial injury treated between year 2000 and 2010 at the University Clinical Center of Kosovo. Seven of these years were prospective and three retrospective study.

Results: The mechanism of arterial injury was stabbing 46.66%, gunshot wounds in 31.66%, blunt in 13.33%, and landmine in 8.33%. The most frequently injured vessel was the superficial femoral artery (25%), followed by the brachial artery (20.9%), crural arteries (13.1%), forearm arteries (14.3%), iliac arteries (7.5%), abdominal aorta (3.3%), common femoral artery (3.3%) and popliteal artery (3.3%). Associated injuries including bone, nerve and remote injury (affecting the head, chest, or abdomen) were present in 24.2% of patients. The decision to operate was made based on the presence of "hard signs" of vascular trauma. Arterial reconstruction was performed in 90.8% of patients, 5.8% of patients underwent primary amputation and 3.2% died on the operation table. Overall survival rate was 95.8%.

Conclusion: Injuries to the arteries are associated with significant mortality and morbidity. Mechanism of injury (blunt, gunshot, landmine or stub), hemodynamic stability at the admission, localization of injury, time from injury to flow restitution, associated injuries to the structures in the region and remote organs are critical factors influencing outcome.

No MeSH data available.


Related in: MedlinePlus

False aneurysm (a) and arteriovenous fistula (b) due to a non recognized arterial trauma.
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Figure 3: False aneurysm (a) and arteriovenous fistula (b) due to a non recognized arterial trauma.

Mentions: In almost all patients, except in four (116/120 or 96.66%), the decision to operate was based on the presence of “hard signs” of vascular trauma. Although, performed only in about half of all trauma patients (63/120 or 52.5%), triplex scan was a powerful tool to support clinical decision. To confirm trauma to the vessels, we had to perform computerized angiotomography in four cases (4/120 or 3.33%). Two injuries were initially missed (2/120 or 1.66%) and presented later as false aneurysm and arteriovenous fistula (Figure 3).


A decade of civilian vascular trauma in Kosovo.

Jaha L, Andreevska T, Rudari H, Ademi B, Ismaili-Jaha V - World J Emerg Surg (2012)

False aneurysm (a) and arteriovenous fistula (b) due to a non recognized arterial trauma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472200&req=5

Figure 3: False aneurysm (a) and arteriovenous fistula (b) due to a non recognized arterial trauma.
Mentions: In almost all patients, except in four (116/120 or 96.66%), the decision to operate was based on the presence of “hard signs” of vascular trauma. Although, performed only in about half of all trauma patients (63/120 or 52.5%), triplex scan was a powerful tool to support clinical decision. To confirm trauma to the vessels, we had to perform computerized angiotomography in four cases (4/120 or 3.33%). Two injuries were initially missed (2/120 or 1.66%) and presented later as false aneurysm and arteriovenous fistula (Figure 3).

Bottom Line: The most frequently injured vessel was the superficial femoral artery (25%), followed by the brachial artery (20.9%), crural arteries (13.1%), forearm arteries (14.3%), iliac arteries (7.5%), abdominal aorta (3.3%), common femoral artery (3.3%) and popliteal artery (3.3%).The decision to operate was made based on the presence of "hard signs" of vascular trauma.Injuries to the arteries are associated with significant mortality and morbidity.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Vascular Surgery, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo. ljaha@yahoo.com.

ABSTRACT

Purpose: We sought to analyze the results of arterial injury management in a busy metropolitan vascular unit and risk factors associated with mortality and morbidity.

Patients and methods: We analyzed 120 patient with arterial injury treated between year 2000 and 2010 at the University Clinical Center of Kosovo. Seven of these years were prospective and three retrospective study.

Results: The mechanism of arterial injury was stabbing 46.66%, gunshot wounds in 31.66%, blunt in 13.33%, and landmine in 8.33%. The most frequently injured vessel was the superficial femoral artery (25%), followed by the brachial artery (20.9%), crural arteries (13.1%), forearm arteries (14.3%), iliac arteries (7.5%), abdominal aorta (3.3%), common femoral artery (3.3%) and popliteal artery (3.3%). Associated injuries including bone, nerve and remote injury (affecting the head, chest, or abdomen) were present in 24.2% of patients. The decision to operate was made based on the presence of "hard signs" of vascular trauma. Arterial reconstruction was performed in 90.8% of patients, 5.8% of patients underwent primary amputation and 3.2% died on the operation table. Overall survival rate was 95.8%.

Conclusion: Injuries to the arteries are associated with significant mortality and morbidity. Mechanism of injury (blunt, gunshot, landmine or stub), hemodynamic stability at the admission, localization of injury, time from injury to flow restitution, associated injuries to the structures in the region and remote organs are critical factors influencing outcome.

No MeSH data available.


Related in: MedlinePlus