Iatrogenic vascular lesions: tactical procedure and late follow-up studies

The problems associated with postoperative iatrogenic vascular lesions in 13 patients are discussed. In general surgery, there is no particular procedure which entails an extremely high risk of iatrogenic vascular lesions. Depending on the kind of lesion, hemorrhage and ischemia are the most frequent symptoms. The IVL was recognized during the initial operation in only two cases. Interposition of autologous saphenous vein is the safest therapeutic procedure. End-to-end anastomosis and patches to enlarge the anastomosis can also be used. In venous lesions, we recommend the creation of a temporary AV-fistula. In one case a thigh amputation was necessary because of progressive venous gangrene; operation was performed five days after the lesion. Postoperatively, two cubital interpositions were occluded; but the patients did not suffer from circulatory problems. One female patient died following resection of a carotid aneurysm originating from a glomectomy. Good postoperative results were reported for the other patients.