Ankara Üniversitesi Tıp Fakültesi Mecmuası

0365-8104 1307-5608

Ankara University

Cardiovascular Surgery

Kalp ve Damar Cerrahisi

Vascular Injuries: Analysis of 115 Cases

Damar Travmaları: 115 Vakanın Analizi

Böre

Erkmen

HACETTEPE UNIVERSITY, SCHOOL OF MEDICINE, MEDICINE PR.

12 31 1972

25 6 1262 1291 10 01 1972 12 30 1972

1947

Ankara Üniversitesi Tıp Fakültesi Mecmuası

Amaç 1964–1972 arasında Hacettepe Üniversitesi Erişkin Göğüs ve Kalp‐Damar Cerrahisi Kliniği’nde cerrahi olarak tedavi edilen 115 travmatik ve iatrojenik damar yaralanmasını analiz etmek.Yöntem 102 erkek, 13 kadın (yaş 16–67) toplam 115 hastanın göğüs, abdomen ve ekstremite damar yaralanmaları retrospektif olarak değerlendirildi. Yarası kurşun (72), bıçak (19), iatrojenik kateter komplikasyonu (9) ve künt travmaydı. Lezyonlar femoral (%53.9), brakial (%11.3), aksiller (%7.0), karotis (%7.0), subklavian (%1.7), popliteal (%10.4), radius/ulnar (%4.3) arter ve büyük venlerdeydi. Teşhis klinik, anjiografik ve osilografik yöntemlerle kondu. Cerrahi tedavi yöntemleri ligasyon, primer anastomoz, safen ven greft yaması, arter greft interpozisyonu ve yardımcı yöntemlerden oluştu.Bulgular Hastaların %75.6’sı sekelsiz iyileşti. Preoperatif nörolojik sekeller %14.7’de devam etti. Amputasyon %7.8, mortalite %2.6 olarak kaydedildi.Sonuç Zamanında ve uygun cerrahi rekonstrüksiyon yüksek sağkalım sağlar. Ekstremite kurtarımı; hasar yeri, müdahale süresi ve onarım tekniğine bağlıdır.

Objective To review 115 traumatic and iatrogenic vascular injuries managed surgically from 1964 to 1972 in the Adult Thoracic and Cardiovascular Surgery Department at Hacettepe University.Methods A retrospective analysis was conducted on 115 patients (102 men, 13 women; ages 16–67) who sustained arterial or venous trauma. Etiologies included gunshot wounds (72), stab injuries (19), iatrogenic catheter complications (9), blunt trauma, and others. Lesion sites were femoral (62), brachial (13), axillary (8), carotid (8), subclavian (2), popliteal (12), radial/ulnar (5), and major veins (2). Diagnostic work‐up employed clinical signs, Doppler/angiography, and oscillography. Treatment consisted of ligation (20%), primary anastomosis (33%), vein patch or saphenous vein interposition (22%), arterial autograft (7%), and supportive measures (fasiotomy, sympathectomy, anticoagulation).Results Good limb function without sequelae was achieved in 75.6% of cases. Preoperative neurological deficits persisted in 14.7%. Amputations were necessary in 7.8%, and mortality was 2.6%, due to hemorrhage, shock, or associated injuries.Conclusion Early recognition and prompt reconstructive surgery yield high success rates. Limb salvage depends on injury location, timing of intervention, and choice of repair technique.

Vascular trauma Arterial injury Femoral artery Surgical repair Interposition graft

Damar travması Arter yaralanması Femoral arter Cerrahi tamir

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