DOI QR코드

DOI QR Code

Case reports of iatrogenic vascular injury in the trauma field: what is the same and what is different?

  • Kim, Youngwoong (Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Choi, Kyunghak (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Choi, Seongho (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Keum, Min Ae (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sungjeep (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kyoung, Kyu-Hyouck (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Jihoon T (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Noh, Minsu (Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine)
  • Received : 2021.09.15
  • Accepted : 2021.12.16
  • Published : 2022.06.30

Abstract

Iatrogenic vascular injury (IVI) can occur with any technique or type of surgery performed around a blood vessel. Patients with severe trauma are at risk of IVI. In this study, we describe our experiences of IVI in the trauma field. We reviewed five patients who were diagnosed with an IVI and received either surgical or endovascular treatment. Of the five patients, one had an arterial injury, three had venous injuries, and one had an arteriovenous fistula, a form of combined arterial and venous injuries. Of the five patients, four had undergone orthopedic surgery. The IVIs of three patients were immediately identified in the operating room and simultaneous vascular repair was performed. The remaining one patient underwent additional surgery for occlusion related to entrapment of the superficial femoral artery by a surgical wire used during orthopedic surgery. Complications presumably related to the IVI were identified in two patients. IVI in trauma patients can be successfully managed, but significant morbidity can occur. If an IVI is suspected, immediate evaluation and management are required.

Keywords

References

  1. Tonnessen BH. Iatrogenic injury from vascular access and endovascular procedures. Perspect Vasc Surg Endovasc Ther 2011;23:128-35. https://doi.org/10.1177/1531003511409057
  2. Giswold ME, Landry GJ, Taylor LM, Moneta GL. Iatrogenic arterial injury is an increasingly important cause of arterial trauma. Am J Surg 2004;187:590-2. https://doi.org/10.1016/j.amjsurg.2004.01.013
  3. Rudstrom H, Bergqvist D, Bjorck M. Iatrogenic vascular injuries with lethal outcome. World J Surg 2013;37:1981-7. https://doi.org/10.1007/s00268-013-2061-2
  4. Yoo TK, Min SK, Ahn S, et al. Major vascular injury during nonvascular surgeries. Ann Vasc Surg 2012;26:825-32. https://doi.org/10.1016/j.avsg.2012.01.010
  5. Mills JL, Wiedeman JE, Robison JG, Hallett JW Jr. Minimizing mortality and morbidity from iatrogenic arterial injuries: the need for early recognition and prompt repair. J Vasc Surg 1986;4:22-7. https://doi.org/10.1016/0741-5214(86)90318-6
  6. Martin MJ, Perez-Alonso AJ, Asensio JA. Vascular complications and special problems in vascular trauma. Eur J Trauma Emerg Surg 2013;39:569-89. https://doi.org/10.1007/s00068-013-0336-9
  7. Liu JL, Li JY, Jiang P, et al. Literature review of peripheral vascular trauma: is the era of intervention coming. Chin J Traumatol 2020;23:5-9. https://doi.org/10.1016/j.cjtee.2019.11.003
  8. Galyfos G, Kerasidis S, Stefanidis G, et al. Iatrogenic and non-iatrogenic arterial injuries in an urban level I trauma center in Greece. Int Angiol 2016;35:526-30.
  9. Rudstrom H, Bergqvist D, Ogren M, Bjorck M. Iatrogenic vascular injuries in Sweden: a nationwide study 1987-2005. Eur J Vasc Endovasc Surg 2008;35:131-8. https://doi.org/10.1016/j.ejvs.2007.09.010
  10. De'Ath HD, Galland RB. Iatrogenic and non-iatrogenic vascular trauma in a district general hospital: a 21-year review. World J Surg 2010;34:2363-7. https://doi.org/10.1007/s00268-010-0647-5
  11. DuBose JJ, Rajani R, Gilani R, et al. Endovascular management of axillo-subclavian arterial injury: a review of published experience. Injury 2012;43:1785-92. https://doi.org/10.1016/j.injury.2012.08.028
  12. Smolevitz J, Daab L, Liem T, Politano A. Hybrid repair of an iatrogenic left subclavian artery injury: a case report. Ann Vasc Surg 2020;67:563.e7-11.