Cervicothoracic vascular injuries. Presentation, management, and outcome

Area of Science:

• Vascular Surgery
• Trauma Management
• Emergency Medicine

Background:

• Cervicothoracic vascular trauma presents complex challenges in diagnosis and management.
• Prompt and accurate intervention is crucial for patient survival and functional recovery.

Purpose of the Study:

• To analyze the characteristics, management, and outcomes of 100 consecutive patients with cervicothoracic vascular trauma.
• To evaluate the effectiveness of different surgical interventions and the role of preoperative imaging.

Main Methods:

• Retrospective analysis of 100 patients with cervicothoracic vascular trauma.
• Data collected included injury severity, mechanism, patient demographics, management strategies, and outcomes.
• Surgical options included primary repair, resection with anastomosis, and ligation.

Main Results:

• A total of 112 arterial and 122 venous injuries were identified across stable, unstable, and morbid patient groups.
• Postoperative complications occurred in 23% of patients, predominantly respiratory issues.
• The overall mortality rate was 6%, with exsanguination and ischemic brain death as primary causes.

Conclusions:

• Surgical repair, including primary repair, resection with anastomosis, or ligation, is effective for cervicothoracic vascular injuries.
• Preoperative angiograms are valuable for surgical planning, particularly in identifying arteriovenous fistulas.
• Despite potential complications and mortality, the overall outcome for cervicothoracic vascular trauma is favorable with appropriate management.