Incidence and patterns of iatrogenic arterial injuries. A decade's experience

To investigate the incidence and patterns of all iatrogenic arterial injuries (IAI) necessitating surgical repair in a ten-year period.

Retrospective study.

Departments of Vascular Surgery a) Athens General Hospital "G. Gennimatas" and b) Red Cross Hospital of Athens, Greece.

Eighty-seven patients underwent surgical repair of an IAI, comprising 36% of the 237 patients treated surgically for various arterial injuries during the same period.

Specific injury patterns were implicated in most cases. Cardiac catheterizations were the commonest cause of IAI (n=39). The second commonest source for IAI was the renal units' personnel accountable for 17 false aneurysms, which arose at arteriovenous grafts' puncture sites. Among the surgical specialties orthopaedic surgery was the most common source of IAI (n=13). A less common pattern of IAI was following radical operations for cancer (n=7). The mortality of the series was 4.6% (4/87) and the amputation rate 2.3% (2/87). No death or amputation was associated with IAI following cardiac catheterizations confirming that post-catheterization IAI have a benign prognosis. False aneurysm was the most frequent complication when the cardiac catheterization was via the femoral artery, when the catheterization was via the brachial artery the commonest complication was arterial thrombosis. The two amputations were due to delayed reconstruction of arterial injuries that were not recognised at first sight.

Common patterns characterize most IAI. Understanding their exact causes is a first step towards prevention or timely repair if the latter is not feasible.