Vascular trauma and its management: one and a half years after the 25th January revolution

ABSTRACT

Vascular trauma is a common life-threatening injury leading to serious consequences if not timely and efficiently managed. Although they represent less than 3% of all injuries, they deserve special attention because of their severe complications. The aim of this study was to analyze the causes of injury, presentations, surgical [recent] approaches, outcomes, and complications of vascular trauma. This was a retrospective analysis performed over 1.5 years. From January 2011 to June 2012, 48 patients were included in the study and were operated upon for peripheral vascular injuries. Diagnosis was made by physical examination as well as with hand Doppler alone or in combination with Doppler scan/angiography. Primary vascular repair was carried out whenever possible; however, if it was not possible, an interposition vein graft was placed. In some patients, endovascular approaches were applied, whereas in other patients a combination of open surgical and endovascular approaches was used [hybrid technique]. Of the total 48 patients who sustained major vascular injuries during this period, 17 sustained injuries to the upper limb vessels, 26 had injuries of the lower limb vessels, two patients had injuries of the abdominal vessels, and three patients had injuries of the neck. A penetrating trauma was the cause in 45 cases and a blunt trauma was the cause in three cases. Of the 48 patients, 46 patients were successfully managed by vascular reconstruction without any residual disability. There were 46 male patients [95.83%] and two female patients [4.16%], and their ages ranged from 17-40 years [mean 28.5 years]. Patients who suffer vascular injuries should be transferred to vascular surgery centers as soon as possible. Decisive management of peripheral vascular trauma will maximize patient survival and limb salvage. Priorities must be established in the management of associated injuries, and delay must be avoided when ischemic changes are present