TREATMENT OF ARTERIAL TRAUMA IN PATIENTS OF VARIOUS AGES

Aim. To identify the differences in arterial trauma (AT) treatment in patients of different ages. Materials and methods. The hospital medical records of 222 patients with AT who were treated in the Lviv Regional Clinical Hospital between 1992 and 2019 were studied. The following patterns were analyzed: age, etiology and mechanism of injury, type of AT, topography, symptoms, type of diagnosis, method of treatment. Patients were divided into seven age groups according to V. Quinn (1994): infants, early childhood, childhood, adolescents, young adults, adults and the elderly. Patients received one of three types of treatment – conservative, surgical or endovascular. Surgical treatment was further divided into simple operations (ligation or suture repair) and complex operations (end-to-end anastomosis or replacement). Results. Conservative treatment was used in 7.66±1.78%, surgical in 90.99±1.92% and endovascular in 1.35±0.77% of clients. The percentage of conservative treatment was higher among the infants (88.9±10.48%) and lower among the young adults (0.9%), as compared to the average. Among the operated patients, simple operations were performed in 48.45±3.59%, and complex operations in 51.55±3.59%. The distribution of different types of simple and complex operations between different age groups was similar. Regression analysis confirmed the influence of age factor, along with the type of AT, on the choice of treatment of patients. In addition, atherosclerotic changes were found in 20% of the adults and 50% of the elderly patients in the AT area. Conclusions. The age category of the patient makes an impact of the treatment method for patients with AT. Differences were related to the children of their first years of life, who were often managed conservatively. In the adults and the elderly, arterial damage may coincide with atherosclerotic changes in the blood vessels

Relationship Between Body Mass Index and Trauma Causing Knee Injury Associated With Popliteal Artery Injury. Monocentric Experience in a High Volume Surgery Center

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.

The Role of Body Mass Index in High and Low Velocity Trauma Causing Knee Injury Associated to Popliteal Artery Lesions.

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.

The Role of Body Mass Index in High and Low Velocity Trauma Causing Knee Injury Associated to Popliteal Artery Lesions.

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.

Arterial Duplex and Palmar Acceleration Time in an Upper Extremity Trauma Case

Subclavian and axillary arterial injuries are uncommon and in the setting of scapulothoracic dissociation present difficulties in diagnosis, assessment, and reconstruction. We present a case of subclavian artery disruption in such a setting, in which palmar duplex identified the need for reperfusion and provided assessment of an extra-anatomic bypass. Palmar arterial duplex may provide a useful tool in select cases of upper extremity arterial trauma.