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Use of microsurgery and iloprost in the infantile arterial injuries
Erkan Iriz1, Dilek Erer, Serdar Kula
1Department of Cardiovascular Surgery, Gazi University. erkaniriz@gmail.com
Insights
Microsurgery and iloprost infusion effectively treat infantile artery injuries and distal ischemia, preventing tissue loss. This combined approach offers a promising solution for these rare pediatric vascular conditions.
Area of Science:
- Pediatric vascular surgery
- Neonatal intensive care
- Pharmacological interventions
Background:
- Infantile artery injuries, often iatrogenic, can lead to critical distal ischemia.
- Delayed diagnosis and treatment increase the risk of tissue necrosis and extremity loss.
Purpose of the Study:
- To evaluate the efficacy of microsurgical intervention and intravenous iloprost in managing infantile artery injuries.
- To assess the advantages of these treatments in preventing distal ischemia and tissue loss.
Main Methods:
- Retrospective analysis of four infants with iatrogenic artery injuries and distal ischemia.
- Comparison of treatment strategies: microsurgery with iloprost versus iloprost alone.
- Follow-up period of 9 months to assess outcomes.
Main Results:
- Two infants with delayed presentation (12+ hours) underwent microsurgery and iloprost, preventing tissue necrosis.
- Two infants presenting earlier (<12 hours) were successfully treated with iloprost alone, avoiding surgical intervention.
- No patients experienced tissue or extremity loss during the follow-up period.
Conclusions:
- Intravenous iloprost infusion is highly effective as an adjunct to conservative treatment for infantile artery injuries.
- Microsurgical intervention combined with iloprost is a viable option for delayed presentations, preserving tissue and extremities.
Background:
To evaluate the use and advantage of microsurgical intervention and intravenous iloprost administration in delayed infantile artery injuries.
Methods And Results:
Four patients were followed up and treated in our clinic between June 2003 and June 2006 for infantile artery injuries and distal ischemia. The average age of the 4 infants (3 girls, 1 boy) was 134.7+/-33.6 days. The reason for all of the artery injuries was iatrogenic. Tissue necrosis started in patches in 2 babies who were admitted at the 12(th) hour after ischemia (19(th) and 22(nd) hours), and therefore the artery was repaired by microsurgery. Iloprost infusion was also used in addition to the conservative treatments. The other 2 patients were assessed before the first 12 h after distal ischemia and were treated by iloprost without any surgical intervention. None of the patients lost any tissue or extremities during the 9 months (average) follow-up time. One of our patients died following the ventricular septal defect repair at the 9(th) month after a successful repair of artery.
Discussion:
We believe that intravenous iloprost infusion is very effective in the treatment of distal ischemia when used in addition to the conservative treatment methods for artery injuries in infants.
