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Peripheral Arterial Injuries in Children: An Audit at a University Hospital in Developing Country
Zia Ur Rehman1, Amna Riaz2, Zafar Nazir3
1Section of Vascular Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
Annals of Vascular Diseases
|June 30, 2020
Summary
Pediatric peripheral arterial injuries (PAIs) are often caused by trauma. Early presentation and vascular repair significantly improve limb salvage rates in children with PAIs.
Area of Science:
- Vascular Surgery
- Pediatric Trauma
- Arterial Injuries
Background:
- Peripheral arterial injuries (PAIs) in children are uncommon but can lead to significant morbidity.
- Understanding the epidemiology and management of pediatric PAIs is crucial for improving outcomes.
Purpose of the Study:
- To determine the prevalence, patterns, management, and outcomes of pediatric PAIs.
- To identify predictive factors for limb loss in pediatric patients with PAIs.
Main Methods:
- Retrospective review of medical records of pediatric patients (<18 years) with PAIs from 2008-2018.
- Data collected included demographics, injury mechanisms, injury type, severity scores (Revised Trauma Score, Mangled Extremity Severity Score), management, and outcomes.
Main Results:
- 75 pediatric patients had PAIs, with common causes including glass cuts, gunshots, and road traffic accidents.
- Brachial, superficial femoral, and radial arteries were most frequently injured.
- Limb salvage was achieved in 92.65% of patients, with late presentation (>6 hours) identified as a risk factor for limb loss (p=0.014).
Conclusions:
- Early presentation (<6 hours) and timely vascular interventions are critical for successful limb salvage in pediatric PAIs.
- Most pediatric PAIs can be successfully managed with appropriate surgical techniques, preserving limb function.
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