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Vascular injuries associated with elective orthopedic procedures.

Jeffrey S Wilson1, Ana Miranda, Brad L Johnson

  • 1Division of Vascular and Endovascular Surgery, University of South Florida College of Medicine, Tampa, FL, USA.

Annals of Vascular Surgery
|October 10, 2003
PubMed
Summary

Iatrogenic arterial injury following elective orthopedic joint procedures is rare (0.005%). Arterial thrombosis is the most common injury, often occurring in patients with prior surgery or atherosclerosis, leading to significant limb morbidity.

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Area of Science:

  • Vascular Surgery
  • Orthopedic Surgery
  • Iatrogenic Injury

Background:

  • Iatrogenic arterial injury is a rare but serious complication of elective orthopedic joint procedures.
  • These injuries can lead to significant morbidity, including limb loss.

Purpose of the Study:

  • To review the diagnosis, management, and outcomes of iatrogenic arterial injury after elective orthopedic joint procedures.
  • To determine the incidence and risk factors associated with these injuries.

Main Methods:

  • Retrospective review of patients with arterial injury after elective orthopedic procedures between 1997 and 2002.
  • Analysis of clinical records for presentation, injury type, management, and outcomes.

Main Results:

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  • The incidence of iatrogenic arterial injury was 0.005% (27 injuries in 20 patients).
  • Arterial thrombosis was the most common injury (78%), followed by laceration/avulsion (11%) and pseudoaneurysm (11%).
  • Risk factors included prior surgery (71%) and pre-existing atherosclerosis (33%). Limb loss occurred in 14% of patients.
  • Conclusions:

    • Iatrogenic arterial injury in elective orthopedic surgery is uncommon but associated with high rates of limb morbidity.
    • Prompt diagnosis and management are crucial, but outcomes are often influenced by pre-existing vascular disease and injury severity.