The Sundt Encircling Clip as a Vascular Rescue: A Case Report and a Review of Repair Methods for Arterial Tearing

The Sundt encircling clip was developed to repair defects of the vessel wall. With the advent of microvascular techniques, most parts of the damaged vessel wall during aneurysm surgery can be repaired by primary closure or by the bypass technique. However, these methods are not always successful. Here, we illustrate two cases of surgical clipping with the Sundt encircling clip in the ruptured internal carotid artery trunk aneurysm. The Sundt clip provides prompt control of unexpected tearing of the vessel wall or aneurysm and plays an important role in vascular rescue during aneurysm surgery.

Is CT Angiography a Reliable Tool for Diagnosis of Traumatic Vessel Injury in the Lower Extremities?

PURPOSE: Computed tomographic (CT) angiography is the first choice of diagnosis in traumatic vessel injury in the lower extremities, replacing angiography. The purpose of this study was to investigate the clinical reliability of CT angiography through a retrospective study. MATERIALS AND METHODS: Seventeen patients underwent CT angiography before surgery for traumatic vessel injury in the lower extremities from 2009 to 2010, and a comparative analysis of operative findings in all patients with a positive predictive value and sensitivity were measured. RESULTS: In all patients, 16 artery ruptures and 1 compartment syndrome occurred. In 15 artery ruptures, preoperative findings of CT angiography and surgical findings were consistent, and the positive predictive value was 93.8%. One patient with posterior tibial artery rupture was revealed as normal in CT angiography; thus, sensitivity was 93.8% (15/16 patients), and the accuracy rate was 88.2% (15/17 patients). CONCLUSION: Though CT angiography is a reliable tool for diagnosis in traumatic vessel injury in the lower extremities, a more invasive test will be needed, especially peripheral angiography or diagnostic exploration, in cases of relatively small vessel injuries around the ankle or compartment syndrome because of low accuracy.

Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy

We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

The treatment of limb bone fracture in combination with main vessel injury / 国际外科学杂志

Objective The treatment of limb bone fracture in combination with main vessel injury wasanalyzed retrospectively.Methods Twenty ccsese were respectively conducted by interlocking intramedullary pin fixation,plate and screw fixation,plate and screw fixation orextemal brace fixation according to the injury conditions of the fractures.Then,vascahr injaries were flexibly dwelt with direct repair,end-to-end anastomosis or blood vessel grafting.Results The-limb save rate in this study is 70%.and the reaoons which csllsed the amputation included:Long ischemia time and serious tissue damage.Conclusion Fractures of the extremities with major vascular injuries should be diagnosed promptly to be conducted properly.In this way,better outcome would be obtained.

The Emergency Interventional Therapy in Closed Vessel Injury Caused by the Pelvis Trauma / 实用放射学杂志

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

The Effects of Temporary Cavity of High-Velocity Missiles on Adjacent Blood Vessels / 中华创伤杂志

Both thigns of the dogs were injured with 5.56mm M193 Bullets. The effects of the temporary cavity of high velocity missiles on the femoral arteries were studied. The displacement of the femoral artery was proportional to the size of the temporary cavity. The partial endothelial injury, Ices of intima, rupture of internal elastic membrane and thrombi were observed in the femoral arteries within 4 cm of residual track. The injuries in the leg with an exit wound were more severe than that in the leg with an entrance wound, the incidence of thrombosis in 24 and 172 hour groups was higher than in 6 hour group.