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2008, Number 5

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Cir Cir 2008; 76 (5)

Vascular trauma: 25-year experience in Aguascalientes, Mexico

Santacruz-Torres A, Díaz-de León RF, Rosas-Cabral A

Language: Spanish
References: 41
Page: 367-372
PDF size: 51.88 Kb.


ABSTRACT

Background: Incidence and prevalence of vascular injury are related to several social and cultural factors. High-speed transportation, urban crime, high level of industrialization, and new diagnostic or therapeutic methods have all contributed to increase the prevalence of these types of injuries. The aim of this work was to describe the pattern of injuries, surgical approaches, outcome, and complications in patients with vascular trauma in our state and to report our experience during the period between 1980 and 2005.
Methods: We conducted an open retrospective study in 124 patients with vascular trauma in the Centenario Hospital Miguel idalgo, Aguascalientes, Mexico.
Results: One hundred four patients were males (83.9%; male:female ratio 5:1) with an age range from 5-62 years (mean: 23 years). We observed 136 injuries in 124 patients; these traumas affected upper extremities in 48 patients (38.7%), lower extremities in 42 (33.9%), abdomen in 20 (16.2%), head or neck in 9 (7.2%) and thorax in 5 (4%). The mechanism of injury was penetration with a sharp object (41.1%), gunshot (37.9%), blunt trauma (16.9%) and iatrogenic (4.1%). A total of 131 reconstructive procedures were used to treat these patients. Forty six patients (37.1%) developed postoperative complications, amputation was done in three patients (2.4%) and three patients died (2.4%). Seventy three patients (58.9%) arrived ‹8 h after trauma.
Conclusions: The prevalence of vascular injuries in our state is similar to other countries and other regions of Mexico. These were related to weapons, different from other reports. Most vascular injuries in our patients were in the upper extremities and these can be managed successfully and with a low rate of complications.


REFERENCES

  1. Compton C, Rhee R. Peripheral vascular trauma. Perpesct Vasc Surg Endovasc Ther 2005:17;297-307.

  2. Instituto Nacional de Estadística, Geografía e Informática. Estadísticas sociodemográficas 1990-2005. México: INEGI;2007.

  3. Castañeda-Gaxiola R. El problema del trauma vascular en México. Cir Gen 2000:22:254-256.

  4. Rich NM, Villavicencio JL. Tratamiento de los traumatismos vasculares. En: Díaz-Ballesteros F, Páramo-Díaz M, eds. Los Grandes Síndromes Vasculares. Tomo II. México: Instituto Mexicano del Seguro Social;1988. pp. 761-808.

  5. DeBakey ME, Simeone FA. Battle injuries of the arteries in World War II: an analysis of 2471 cases. Ann Surg 1946;123:534-535.

  6. Hughes CW. Arterial repair during the Korean War. Ann Surg 1958;147:555-561.

  7. Inui FK, Shannon J, Howard JM. Arterial injuries and the Korean Conflict: experiences with 111 consecutive injuries. Surgery 1955;37:850-857.

  8. De Bakey M. Five thousand seven hundred sixty cardiovascular injuries in 445 patients: epidemiologic evolution 1958 to 1987. Ann Surg 1989;209: 698-705.

  9. Rich NM, Burris DG. “The long red line”. J Trauma 2003;55:1004-1005. 10. Griswold ME, Landry GJ, Taylor LM, Moneta LM. Iatrogenic arterial injury is an increasingly important cause of arterial trauma. J Am J Surg 2004;187:590-592.

  10. Oderich GS, Panneton JM, Hofer J, Bower TC, Cherry KJ Jr, Sullivan T, et al. Iatrogenic operative injuries of abdominal and pelvic veins: a potentially lethal complication. J Vasc Surg 2004;39:931-936.

  11. Caps MT. The epidemiology of vascular trauma. Semin Vasc Surg 1998;11:227-231.

  12. Thomas MO, Giwa SO, Adekaya-Cole TO. Arterial injuries in civilian practice in Lagos, Nigeria. Niger J Clin Pract 2005;8:65-68.

  13. Ramírez-González AH. Trauma vascular. Experiencia en la práctica privada (1982-1993). Rev Mex Angiol 1996;24:6-10.

  14. Hussain ST, Aslam S, Khan RA, Mannan P, Khan J, Collin J. Observational study of 256 cases of vascular trauma in the north eastern province of Pakistan. Ann R Coll Surg Engl 2001;83:388-391.

  15. Asfar S, Al-Ali J, Safar H, Al-Bader M, Farid E, Ali A. et al. 155 vascular injuries, a retrospective study (1992-2000). Eur J Surg 2002;168:626-630.

  16. Abouezzi Z, Nassoura Z, Ivatury RR, Porter JM, Stahl WM. A critical reappraisal of indications for fasciotomy after extremity vascular trauma Arch Surg 1998;8133:547-551.

  17. Sigler-Morales L, Castañeda-Gaxiola R, Rish-Fein L, Rodríguez-Trejo JM, Padilla-Sánchez L, Gutiérrez-Carreño R. Lesiones vasculares por iatrogenia. Revisión de 140 pacientes. Rev Mex Angiol 2005;33:42-49.

  18. Ramírez-González AH, Pérez-Villagómez Y, Tena-Martínez I. Iatrogenia en trauma vascular. Rev Mex Angiol 2006;34:141-146.

  19. Rojas GA, Cervantes J. Lesiones vasculares iatrogénicas. Rev Mex Angiol 1999;27:89-94.

  20. Asensio JA, Chahwan S, Hanpeter D, Demetriades D, Forno W, Gambaro E, et al. Operative management and outcome of 302 abdominal vascular injuries. Am J Surg 2000;180:528-533.

  21. Davidovic LB, Cinara IS, Ille T, Kostic DM, Dragas MW, Markovic DM. Civil and war peripheral arterial trauma: review of risk factors associated with limb loss. Vascular 2005;13:141-147.

  22. Ramírez-González AH, Pérez-Villagómez Y, Ayala A, Estrada G, Camargo- Ponce De León F, Estrada H. Lesión vascular traumática de las extremidades superiores. Experiencia en Uruapan, Michoacán, México. Rev Mex Angiol 2004;32:77-83.

  23. Bhargava JS, Kumar R, Singh RB, Makkar A. Civilian vascular trauma: an experience of 54 cases. J Indian Med Assoc 1996;94:47-52.

  24. Menakuru SR, Behera A, Jindal R, Karman L, Doley R, Venkatesan R. Extremity vascular trauma in civilian population: a seven-year review from North India. Injury 2005;36:400-406.

  25. Clouse WD, Rasmussen TE, Pick MA, Eliason JL, Cox MW, Bowser AN, et al. In theater management of vascular injury: 2 years of the Balad vascular registry. J Am Coll Surg 2007;204:625-632.

  26. Weber MA, Fox CJ, Adams E, Rice RD, Quan R, Cox MW, Guillespie DL. Upper extremity arterial combat injury management. Perspect Vasc Surg Endovasc Ther 2006;18:141-145.

  27. Guraya SY. Extremity vascular trauma in Pakistan. Saudi Med J 2004;25:498-501.

  28. Rasmussen TE, Clouse WD, Jenkins DH, Peck MA, Eliason JL, Smith DL. The use of temporary vascular shunts as a damage control adjunct in the management of wartime vascular injury. J Trauma 2006;61:8-12.

  29. Rozycki GS, Tremblay LN, Feliciano DV, McClelland WB. Blunt vascular trauma in the extremity: diagnosis, management, and outcome. J Trauma 2003;55:814-824.

  30. Sternberg WC, Conners MS 3rd, Ojeda MA, Money SR. Acute bilateral iliac occlusion secondary to blunt trauma: successful endovascular treatment. J Vasc Surg 2003;38:589-592.

  31. Yavuz S. ICVTS on-line discussion B traumatic venous injury: ligation or repair? Interact Cardiovasc Thorac Surg 2007;6:650-651.

  32. Nitecki S, Karram T, Hoffman A, Bass A. Venous trauma in the Lebanon war 2006. Interact CardioVasc Thorac Surg 2007;6:647-650.

  33. Yelon JA, Scalea TM, Mullins RJ, Kerstein M, Shackford S, Hirsch E, et al. Venous injuries of the lower extremities and pelvis: repair versus ligation. J Trauma 1992;33:532–538.

  34. Kuralay E, Demirkiliç U, Özal E, Savas Öz B, Cingöz F, Gunay C. A quantitative approach to lower extremity vein repair. J Vasc Surg 2002;36:1213-1218.

  35. Cardneau JD, Henke PK, Upchurch GR Jr, Wakefield TW, Graham LM, Jacobs LA, et al. Efficacy and durability of autogenous saphenous vein conduits for lower extremity arterial reconstructions in preadolescent children. J Vasc Surg 2001;34:34-40.

  36. Pikoulis E, Rhee P, Nishibe T, Burris D, Leppäniemi AK, Fishback N, et al. Arterial repair with synthetic patch by using titanium clips. J Trauma 2000;48:292-295.

  37. Chen MY, Regan JD, D’Amore MJ, Routh WD, Meredith JW, Dyer RB. Role of angiography in the detection of aortic branch vessel injury after blunt thoracic trauma. J Trauma 2001;51:1166-1172.

  38. Quan RW, Adams ED, Cox MW, Eagleton MJ, Weber MA, Fox CJ, et al. The management of trauma venous injury: civilian and wartime experiences. Perspect Vasc Surg Endovasc Ther 2006;18:149-156.

  39. Willy C, Voelker HU, Steinmann R, Engelhardt M. Patterns of injury in a combat environment: 2007 update. Chirurg 2008;79:66-76.

  40. Clouse WD, Rasmussen TE, Perlstein J, Sutherland MJ, Jenkins DH. Upper extremity vascular injury: a current in-theather wartime report from Operation Iraqui Freedom. Ann Vasc Surg 2006;20:429-434.

  41. Galambos B, Tamas L, Zsoldos P, Czigany T, Jakab L, Nemeth J, et al. Vascular injuries in everyday practice. Zentralbl Chir 2004;129:81-86.




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