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Iliac vessel injuries.

James T Lee1, Frederic S Bongard

  • 1Division of Vascular Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA. jtlee@humc.edu

The Surgical Clinics of North America
|March 22, 2002
PubMed
Summary

Managing iliac vascular trauma is challenging, with high mortality from bleeding and associated injuries. This review covers current strategies, PTFE use in contaminated fields, and the emerging role of endovascular techniques.

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Area of Science:

  • Trauma Surgery
  • Vascular Surgery
  • Surgical Management

Background:

  • Iliac vascular trauma presents significant management challenges.
  • Penetrating injuries to this region are associated with high mortality rates, often approaching 40% in reported series.
  • Uncontrollable hemorrhage and associated injuries contribute to the high mortality.

Purpose of the Study:

  • To discuss current management strategies for iliac vascular trauma.
  • To review the controversial use of polytetrafluoroethylene (PTFE) grafts in contaminated surgical fields.
  • To address concomitant injuries and postoperative care, including anticoagulation and fasciotomy complications.

Main Methods:

  • Review of existing literature on iliac vascular trauma management.
  • Discussion of surgical reconstruction techniques, including the use of PTFE grafts.
  • Exploration of adjunctive endovascular therapies.

Main Results:

  • High mortality rates persist for penetrating iliac vascular injuries.
  • The use of PTFE in contaminated fields remains controversial.
  • Endovascular therapy is emerging as a valuable adjunctive tool.

Conclusions:

  • Effective management of iliac vascular trauma requires a comprehensive approach.
  • Careful consideration of graft material and surgical field contamination is crucial.
  • Integration of endovascular techniques can improve outcomes for trauma surgeons.

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