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ORIGINAL ARTICLES  VASCULAR PAPERS 

The Journal of Cardiovascular Surgery 1998 June;39(3):281-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Incidence and patterns of iatrogenic arterial injuries. A decade’s experience

Lazarides M. K., Tsoupanos S. S., Gergopoulos S. E.*, Chronopoulos A. V.*, Arvanitis D. P., Doundoulakis N. J.*, Dayantas J. N.

From the Department of Vascular Surgery Athens General Hospital “G. Gennimatas” and *Red Cross Hospital, Athens, Greece


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Objective. To inves­ti­gate the inci­dence and pat­terns of all iat­ro­gen­ic arte­ri­al inju­ries (IAI) neces­si­tat­ing sur­gi­cal ­repair in a ten-­year peri­od.
Design. Retrospective ­study
Setting. Departments of Vascular Surgery a) Athens General Hospital “G. Gennimatas” and b) Red Cross Hospital of Athens, Greece
Patients. Eighty-sev­en ­patients under­went sur­gi­cal ­repair of an IAI, com­pris­ing 36% of the 237 ­patients treat­ed sur­gi­cal­ly for var­i­ous arte­ri­al inju­ries dur­ing the ­same peri­od.
Results. Specific inju­ry pat­terns ­were impli­cat­ed in ­most cas­es. Cardiac cath­et­er­iza­tions ­were the com­mon­est ­cause of IAI (n=39). The sec­ond com­mon­est ­source for IAI was the ­renal ­units’ per­son­nel account­able for 17 ­false aneu­rysms, ­which ­arose at arter­i­ov­e­nous ­grafts’ punc­ture ­sites. Among the sur­gi­cal spe­cial­ities ortho­paed­ic sur­gery was the ­most com­mon ­source of IAI (n=13). A ­less com­mon pat­tern of IAI was fol­low­ing rad­i­cal oper­a­tions for can­cer (n=7). The mor­tal­ity of the ­series was 4.6% (4/87) and the ampu­ta­tion ­rate 2.3% (2/87). No ­death or ampu­ta­tion was asso­ciat­ed ­with IAI fol­low­ing car­diac cath­et­er­iza­tions con­firm­ing ­that post­cath­et­er­iza­tion IAI have a ­benign prog­no­sis. False aneu­rysm was the ­most fre­quent com­pli­ca­tion ­when the car­diac cath­et­er­iza­tion was via the femo­ral ­artery, ­when the cath­et­er­iza­tion was via the bra­chi­al ­artery the com­mon­est com­pli­ca­tion was arte­ri­al throm­bo­sis. The two ampu­ta­tions ­were due to ­delayed recon­struc­tion of arte­ri­al inju­ries ­that ­were not rec­og­nised at ­first ­sight.
Conclusion. Common pat­terns char­ac­ter­ize ­most IAI. Understanding ­their ­exact caus­es is a ­first ­step ­towards pre­ven­tion or time­ly ­repair if the lat­ter is not fea­sible.

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