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Online ISSN 1827-1847
Angelini R., Eusebio A., Spigonardo F.
Vascular Surgery Unit SS. Annunziata Hospital, Chieti, Italy
Aim. The incidence of iatrogenic vascular traumas (IVT) has registered in the last decades a progressive increase, primarily due to the major use of arterial catheterism. The authors report their experience in the Vascular Surgery Unit of the “SS Annunziata” Hospital, Chieti, Italy, during the last 8 years.
Methods. From April 1997 to June 2005, 46 patients with IVT underwent surgical repair. Average age was 70 years (range 47-87) with a particular increase of incidence from 70 to 79 years; most of patients were males (74.42%). Of the 46 patients, 42 (91.3%) reported IVT after arterial catheterization, 3 (6.90%) after nephrologic procedures and 1 (1.8%) after diagnostic bronchoscopy. Common femoral artery was the most common site of lesions, followed by superficial femoral artery, humeral artery, external iliac artery, deep femoral artery, common carotid and inner jugular vein. Diagnosis was obtained in 20 cases by simple echography, in 17 cases by Doppler sonography, in 2 by CT and in 2 by angiography. In 43 cases surgical repair was performed within 3 h after trauma, in 1 after 4 h, in 1 after 3 days and in 1 after 10 days; 35 patients underwent hematoma drainage and simple vascular repair, while more complex surgical procedures (thromboendarterectomy + patch, bypass or prosthetic grafts) were performed in 11 cases.
Results. Forty-four patients did not develop postoperative complications; permanent venous lymphatic insufficiency occurred in 1 case. One patient died in postoperative day 27 for multi-organ failure.
Conclusion. The most suitable strategies for diagnosis and the therapeutic approach and methods of support to surgery in case of IVT are discussed as well as the main techniques responsible of these kinds of lesions.