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Iatrogenic vascular trauma

M R Nehler1, L M Taylor, J M Porter

  • 1Department of Surgery, University of Colorado Health Sciences Center, Denver, USA.

Seminars in Vascular Surgery
|January 6, 1999
PubMed
Summary
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Increasingly large arterial punctures from medical devices cause vascular injuries. Vascular surgeons manage these iatrogenic injuries, including hemorrhage, pseudoaneurysm, and arterial rupture.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Trauma Surgery

Background:

  • Percutaneous transluminal angioplasty and intravascular device use are increasing, leading to larger arterial punctures.
  • A significant number of these procedures result in vascular injuries requiring intervention.
  • Regionalized trauma care exposes vascular surgeons primarily to iatrogenic vascular trauma.

Purpose of the Study:

  • To review the spectrum of iatrogenic vascular injuries encountered in modern practice.
  • To identify common causes and patterns of these injuries.
  • To highlight differences in pediatric iatrogenic vascular trauma.

Main Methods:

  • Review of common iatrogenic vascular injuries from percutaneous vascular instrumentation, angioplasty/stenting, and indwelling devices.

Related Experiment Videos

  • Analysis of less common injuries from orthopedic and abdominal/laparoscopic operations.
  • Consideration of pediatric iatrogenic vascular trauma characteristics.
  • Main Results:

    • Common injuries include hemorrhage, pseudoaneurysm, fistula, acute occlusion, and embolization from vascular instrumentation.
    • Specific injuries like arterial rupture and dissection are associated with balloon angioplasty/stenting.
    • Indwelling devices can cause arterial rupture, thrombosis, and embolization.

    Conclusions:

    • Iatrogenic vascular trauma is a significant complication of interventional procedures.
    • Understanding injury patterns is crucial for effective management by vascular surgeons.
    • Pediatric iatrogenic vascular trauma presents unique challenges in natural history and management.