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Vascular Injuries: Analysis of 115 Cases

Year 1972, Volume: 25 Issue: 6 , 1262 - 1291 , 31.12.1972
https://izlik.org/JA25DK46KF

Abstract

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.

References

  • 1. Vollmar J.: Rekonstruktive Chirurgie der Arterien. Georg Thieme Verlag, Stuttgart, 1967, p. 82.
  • 2. Linder F., Vollmar J.: Der augenblickliche Stand der Behandlung von Schlagaderverletzungen und Ihrer Folgezustände. Chirurg. 1965;36:55.
  • 3. Garrison FH.: An Introduction to the History of Medicine. 4th ed. W.B. Saunders Co., Philadelphia, 1963, p. 225.
  • 4. DeBakey ME, Simeone FA.: Battle injuries of the arteries in World War II. Ann Surg. 1946;123:534.
  • 5. DeBakey ME, Simeone FA.: Acute battle‐incurred arterial injuries. In: Vascular Surgery in World War II, Elkin DC, DeBakey ME, eds. U.S. Gov. Printing Office, 1955.
  • 6. Levitsky S, James PM, Anderson RW, Hardaway RM.: Vascular trauma in Vietnam battle casualties: Analysis of 55 cases. Ann Surg. 1968;168:831.
  • 7. Heberer G, Rau G, Löhr HH.: Aorta und große Arterien. Springer, Berlin, 1966, p. 448.
  • 8. Heberer G.: Ruptures and aneurysms of the thoracic aorta after blunt chest trauma. J Cardiovasc Surg. 1971;12:115.
  • 9. Erichsen HC, Sørensen HR.: Arterial injuries: Iatrogenic and non‐iatrogenic. Acta Chir Scand. 1969;135:133.
  • 10. Langlois J, Binet JP, Jegen D.: Traumatic rupture of the thoracic aorta and its branches. J Cardiovasc Surg. 1971;12:83.
  • 11. Bross W, Koczorowski S, Bross T, Koltowski R, Olejak B.: Traumatic injuries of great vessels. J Cardiovasc Surg. 1971;12:104.
  • 12. Michaud P, Chassignolle J, Termet H, et al.: Traumatic aneurysms of the aorta: Analysis of 11 observations. J Cardiovasc Surg. 1971;12:121.
  • 13. Mallet‐Guy P, Michoulier J, Ferrée LF, Dolniski J, Galindo F, Leroy J.: Experimentelle Untersuchungen über die Lymphzirkulation der Leber. Perméation biliolymphatique und bilio‐sanguine. Lyon Chir. 1964;60:816.
  • 14. Thomas KE, Sewell DH, Lower RR.: Single homograft aortic cusp replacement: Experimental and clinical observations. Circulation. 1972;45(suppl I):25.
  • 15. Beall AC Jr, Dietrich EB, Morris GC, DeBakey ME.: Surgical management of vascular trauma. Surg Clin North Am. 1966;46:1001.
  • 16. Chandler JG, Knapp RW.: Early definitive treatment of vascular injuries in the Vietnam conflict. JAMA. 1967;202:136.
  • 17. Chandler JG, Knapp RW, et al.: Vascular injuries in Vietnam. An analysis of civilian casualty experience. Ann Surg. 1968;168:831.
  • 18. Elliott JA.: Acute arterial occlusion: An unusual cause. Surgery. 1956;39:825.
  • 19. Aho AJ, Inberg MV, Wegelius U.: Dislocation of the knee with total rupture of the popliteal artery. Acta Chir Scand. 1971;137:387.
  • 20. Eger M, Huler T, Hirsch M.: Popliteal artery occlusion associated with knee dislocation. Br J Surg. 1970;57:315.
  • 21. Schildberg FW, Larena A.: Verletzungen der Extremitätenarterien im Zusammenhang mit Knochenbrüchen. Mschr Unfallheilk. 1971;74:301.
  • 22. Baker LD, Leshin SJ, Mathur VS, Messer JV.: Routine Fogarty thrombectomy in arterial catheterization. N Engl J Med. 1968;279:1203.
  • 23. Blümel VJ, Goerttler U, Schlosser V.: Beitrag zur Pathogenese und Therapie der Arterienverletzungen. Fortschr Med. 1971;89:401.
  • 24. Domanig E Jr, Staudacher M, Wolner E.: Zur Verletzung der Arterien der oberen Extremität. Zentralbl Chir. 1971;77:326.
  • 25. Dale WA.: Autogenous vein grafts for femoro‐popliteal arterial repair. Surg Gynecol Obstet. 1966;123:1282.
  • 26. Wylie EJ.: Vascular replacement with arterial autografts. Surgery. 1965;57:14.
  • 27. Rosenberg N, Henderson J, Lord GH, Bothwell JW.: An arterial prosthesis of heterologous vascular origin. JAMA. 1964;187:741.
  • 28. Keshishian JM, Smyth NPD, Adkins PC, Camp F, Yahr WZ.: Bovine arterial graft surgical techniques. Surg Gynecol Obstet. 1971;133:268.
  • 29. Moncrief JA, Darrin JC, Canizaro PC, Sawyer RR.: Use of dextran to prevent arterial and venous thrombosis. Ann Surg. 1963;158:553.
  • 30. Shires GT.: Trauma. In: Principles of Surgery, Schwartz SI, ed. McGraw-Hill, New York, 1969, p. 196.
  • 31. Clain A.: The Heart and Great Vessels. In: Hamilton Bailey’s Emergen­ cy Surgery, McNair TJ, ed. John Wright & Sons, Bristol, 1967, p. 363.
  • 32. Bozer AY, Hufnagel CA.: Migration of a bullet from systemic vein to the right ventricle. Acta Med Turc. 1966;3:186.
  • 33. Saylam A, Bozer AY, Kadıoğlu Y.: Migration of a bullet from the inferior vena cava to the right pulmonary artery. Jap Heart J. 1972;13:572.
  • 34. Lampson RS.: Traumatic chylothorax treated by mediastinal ligation of the thoracic duct. J Thorac Surg. 1948;17:778.

Damar Travmaları: 115 Vakanın Analizi

Year 1972, Volume: 25 Issue: 6 , 1262 - 1291 , 31.12.1972
https://izlik.org/JA25DK46KF

Abstract

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.

References

  • 1. Vollmar J.: Rekonstruktive Chirurgie der Arterien. Georg Thieme Verlag, Stuttgart, 1967, p. 82.
  • 2. Linder F., Vollmar J.: Der augenblickliche Stand der Behandlung von Schlagaderverletzungen und Ihrer Folgezustände. Chirurg. 1965;36:55.
  • 3. Garrison FH.: An Introduction to the History of Medicine. 4th ed. W.B. Saunders Co., Philadelphia, 1963, p. 225.
  • 4. DeBakey ME, Simeone FA.: Battle injuries of the arteries in World War II. Ann Surg. 1946;123:534.
  • 5. DeBakey ME, Simeone FA.: Acute battle‐incurred arterial injuries. In: Vascular Surgery in World War II, Elkin DC, DeBakey ME, eds. U.S. Gov. Printing Office, 1955.
  • 6. Levitsky S, James PM, Anderson RW, Hardaway RM.: Vascular trauma in Vietnam battle casualties: Analysis of 55 cases. Ann Surg. 1968;168:831.
  • 7. Heberer G, Rau G, Löhr HH.: Aorta und große Arterien. Springer, Berlin, 1966, p. 448.
  • 8. Heberer G.: Ruptures and aneurysms of the thoracic aorta after blunt chest trauma. J Cardiovasc Surg. 1971;12:115.
  • 9. Erichsen HC, Sørensen HR.: Arterial injuries: Iatrogenic and non‐iatrogenic. Acta Chir Scand. 1969;135:133.
  • 10. Langlois J, Binet JP, Jegen D.: Traumatic rupture of the thoracic aorta and its branches. J Cardiovasc Surg. 1971;12:83.
  • 11. Bross W, Koczorowski S, Bross T, Koltowski R, Olejak B.: Traumatic injuries of great vessels. J Cardiovasc Surg. 1971;12:104.
  • 12. Michaud P, Chassignolle J, Termet H, et al.: Traumatic aneurysms of the aorta: Analysis of 11 observations. J Cardiovasc Surg. 1971;12:121.
  • 13. Mallet‐Guy P, Michoulier J, Ferrée LF, Dolniski J, Galindo F, Leroy J.: Experimentelle Untersuchungen über die Lymphzirkulation der Leber. Perméation biliolymphatique und bilio‐sanguine. Lyon Chir. 1964;60:816.
  • 14. Thomas KE, Sewell DH, Lower RR.: Single homograft aortic cusp replacement: Experimental and clinical observations. Circulation. 1972;45(suppl I):25.
  • 15. Beall AC Jr, Dietrich EB, Morris GC, DeBakey ME.: Surgical management of vascular trauma. Surg Clin North Am. 1966;46:1001.
  • 16. Chandler JG, Knapp RW.: Early definitive treatment of vascular injuries in the Vietnam conflict. JAMA. 1967;202:136.
  • 17. Chandler JG, Knapp RW, et al.: Vascular injuries in Vietnam. An analysis of civilian casualty experience. Ann Surg. 1968;168:831.
  • 18. Elliott JA.: Acute arterial occlusion: An unusual cause. Surgery. 1956;39:825.
  • 19. Aho AJ, Inberg MV, Wegelius U.: Dislocation of the knee with total rupture of the popliteal artery. Acta Chir Scand. 1971;137:387.
  • 20. Eger M, Huler T, Hirsch M.: Popliteal artery occlusion associated with knee dislocation. Br J Surg. 1970;57:315.
  • 21. Schildberg FW, Larena A.: Verletzungen der Extremitätenarterien im Zusammenhang mit Knochenbrüchen. Mschr Unfallheilk. 1971;74:301.
  • 22. Baker LD, Leshin SJ, Mathur VS, Messer JV.: Routine Fogarty thrombectomy in arterial catheterization. N Engl J Med. 1968;279:1203.
  • 23. Blümel VJ, Goerttler U, Schlosser V.: Beitrag zur Pathogenese und Therapie der Arterienverletzungen. Fortschr Med. 1971;89:401.
  • 24. Domanig E Jr, Staudacher M, Wolner E.: Zur Verletzung der Arterien der oberen Extremität. Zentralbl Chir. 1971;77:326.
  • 25. Dale WA.: Autogenous vein grafts for femoro‐popliteal arterial repair. Surg Gynecol Obstet. 1966;123:1282.
  • 26. Wylie EJ.: Vascular replacement with arterial autografts. Surgery. 1965;57:14.
  • 27. Rosenberg N, Henderson J, Lord GH, Bothwell JW.: An arterial prosthesis of heterologous vascular origin. JAMA. 1964;187:741.
  • 28. Keshishian JM, Smyth NPD, Adkins PC, Camp F, Yahr WZ.: Bovine arterial graft surgical techniques. Surg Gynecol Obstet. 1971;133:268.
  • 29. Moncrief JA, Darrin JC, Canizaro PC, Sawyer RR.: Use of dextran to prevent arterial and venous thrombosis. Ann Surg. 1963;158:553.
  • 30. Shires GT.: Trauma. In: Principles of Surgery, Schwartz SI, ed. McGraw-Hill, New York, 1969, p. 196.
  • 31. Clain A.: The Heart and Great Vessels. In: Hamilton Bailey’s Emergen­ cy Surgery, McNair TJ, ed. John Wright & Sons, Bristol, 1967, p. 363.
  • 32. Bozer AY, Hufnagel CA.: Migration of a bullet from systemic vein to the right ventricle. Acta Med Turc. 1966;3:186.
  • 33. Saylam A, Bozer AY, Kadıoğlu Y.: Migration of a bullet from the inferior vena cava to the right pulmonary artery. Jap Heart J. 1972;13:572.
  • 34. Lampson RS.: Traumatic chylothorax treated by mediastinal ligation of the thoracic duct. J Thorac Surg. 1948;17:778.
There are 34 citations in total.

Details

Primary Language English
Subjects Cardiovascular Surgery
Journal Section Research Article
Authors

Erkmen Böre This is me

Publication Date December 31, 1972
IZ https://izlik.org/JA25DK46KF
Published in Issue Year 1972 Volume: 25 Issue: 6

Cite

APA Böre, E. (1972). Damar Travmaları: 115 Vakanın Analizi. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 25(6), 1262-1291. https://izlik.org/JA25DK46KF
AMA 1.Böre E. Damar Travmaları: 115 Vakanın Analizi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1972;25(6):1262-1291. https://izlik.org/JA25DK46KF
Chicago Böre, Erkmen. 1972. “Damar Travmaları: 115 Vakanın Analizi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 25 (6): 1262-91. https://izlik.org/JA25DK46KF.
EndNote Böre E (December 1, 1972) Damar Travmaları: 115 Vakanın Analizi. Ankara Üniversitesi Tıp Fakültesi Mecmuası 25 6 1262–1291.
IEEE [1]E. Böre, “Damar Travmaları: 115 Vakanın Analizi”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 25, no. 6, pp. 1262–1291, Dec. 1972, [Online]. Available: https://izlik.org/JA25DK46KF
ISNAD Böre, Erkmen. “Damar Travmaları: 115 Vakanın Analizi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 25/6 (December 1, 1972): 1262-1291. https://izlik.org/JA25DK46KF.
JAMA 1.Böre E. Damar Travmaları: 115 Vakanın Analizi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1972;25:1262–1291.
MLA Böre, Erkmen. “Damar Travmaları: 115 Vakanın Analizi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 25, no. 6, Dec. 1972, pp. 1262-91, https://izlik.org/JA25DK46KF.
Vancouver 1.Erkmen Böre. Damar Travmaları: 115 Vakanın Analizi. Ankara Üniversitesi Tıp Fakültesi Mecmuası [Internet]. 1972 Dec. 1;25(6):1262-91. Available from: https://izlik.org/JA25DK46KF