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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
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.
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:
- 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.