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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2006, Number 1

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Rev Mex Angiol 2006; 34 (1)

Use of the autologous hypogastric artery as a vascular graft in the treatment of the peripherical arterial lesions in pediatric patients

Rojas GA, Álvarez ACA, Cervantes J, Cervera A

Language: Spanish
References: 18
Page: 22-25
PDF size: 71.67 Kb.


ABSTRACT

Introduction: Because of mismatch in size and potential growth of the patient, the ideal graft to repair pediatric vascular injuries is not an easy task.
We present our experience from January 1988-July 2005 with the autologous hypogastric artery as a free interposition graft in four pediatric patients (two boys and two girls), age 7-12 years old, that sustained arterial injuries: two in the superficial femoral (SFA), one in the external iliac (EIA) and another one in the axillary artery (AA).
Mechanism of trauma: Penetrating three cases (one laceration of the SFA with a steel rod, one laceration of the SFA with a boat propeller and one injury to the AA with a packing steel belt) and one case of iatrogenic vascular trauma to the EIA during an inguinal hernia repair.
Concomitant injuries: Brachial plexus in one case, superficial femoral (SFV) vein in two and femur fracture in one.
Clinical symptoms: Bleeding in two, ischemia in one and pseudoaneurysm in one.
Surgical technique: In all the cases a segmental resection of the injuried artery was performed, and a free interposition graft repair using the hypogastric artery with proximal and distal end-to-end anastomosis with interrupted sutures with 7-0 or 8-0 polypropylene. In both patients with injuries to the SFV, a ligation was performed.
Results: There was no mortality. Morbidity: paresis of the upper extremity secondary to injury of the brachial plexus in the case of AA injury.
There was a 100% limb salvage rate, and in a follow-up of 3 to 17 years all grafts are pervious.
Conclusions: In spite of the few reported cases with the autologous hypogastric artery as a free interposition graft to repair pediatric peripheral arterial injuries, it is an excellent option to keep in the repertory of the vascular surgeon.


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