Missed vascular injuries: presentation and outcome.

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Diagnostic Imaging

Background:

• Missed vascular injuries can lead to significant morbidity and mortality if not promptly diagnosed and managed.
• Delayed diagnosis of vascular trauma presents unique challenges in presentation and treatment.

Purpose of the Study:

• To characterize the diverse presentations, diagnostic approaches, management strategies, and outcomes of patients with missed vascular injuries.
• To analyze the common etiologies and affected anatomical locations of delayed-onset vascular complications.

Main Methods:

• A case series was conducted involving patients with vascular injuries initially missed at the time of trauma.
• Diagnostic evaluation included computed tomography (CT) or conventional angiography.
• Management involved open vascular surgical techniques, with outcomes assessed.

Main Results:

• Twenty-eight patients with missed vascular injuries were treated, with pseudoaneurysm being the most common presentation (42.8%).
• Low-velocity penetrating trauma was the primary cause (67.8%), often affecting lower limb vessels (71.4%).
• Interposition reverse autogenous saphenous vein graft was the predominant surgical repair method.

Conclusions:

• Low-velocity penetrating trauma frequently results in missed vascular injuries, with pseudoaneurysm as the most common manifestation.
• Effective surgical management, particularly with autogenous vein grafts, can achieve positive outcomes for these delayed vascular injuries.