Treatment of acute neonatal vascular injuries—The utility of multiple interventions

Friedman, Jeffrey D.; Fabre, J; Netscher, David T.; Jaksic, Tom

doi:10.1016/s0022-3468(99)90764-9

Cited by 48 publications

(57 citation statements)

References 18 publications

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“…Therefore, medical management is more commonly recommended. 577 Some, however, advocate surgical treatment 39,[632][633][634][635] and report good results. No study has compared the various management approaches prospectively.…”

Section: Post-cardiac Catheterization Arterial Thrombosismentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

298

245

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Section: Post-cardiac Catheterization Arterial Thrombosismentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

298

245

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“…Another rare cause of vascular injury can be observed after malignant tumor resections. These situations require the use of surgery for vascular reconstruction; however, in infants, there is literature available to support the effectiveness of such procedures when arteries or veins of relatively small diameter (0.3 to 1 mm) are involved [4,7,13]. Also, if the tumor involved major peripheral vessels, the patient would have subacute or chronic vascular compression.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Common Femoral Artery Ligation after Sarcoma Resection in an Infant

Aponte-Tinao

Farfalli

Ayerza

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Vascular reconstruction in infants constitutes a surgical challenge and is indicated frequently for acute occlusions. With the presence of a subacute vascular occlusion, including that produced by tumor resection, collateral circulation develops quickly. Thus a surgeon can consider tumor and vessel resection, without the need for vascular reconstruction. Case Description We report the 2-year postoperative outcome of a 2-month-old boy who had a groin synovial cell sarcoma with vascular involvement, treated using limb salvage surgery with resection of the femoral vessels and without performing vascular reconstruction. Literature Review In adults with military wounds, ligation of the superficial femoral artery and common femoral artery reportedly result in amputation rates of 54% and 86%, respectively. Infants with a common femoral artery ligation may have a lower amputation rate because of some congenital collateral vessels, such as the sciatic artery. Further, when tumors involve major peripheral vessels, subacute or chronic vascular compression likely would facilitate development of collateral circulation. Similar chronic situations have been described in adults treated with debridement and common femoral artery ligation, after infected femoral artery pseudoaneurysms. Purposes and Clinical Relevance Considering our patient's history and clinical and radiographic findings, infants with musculoskeletal sarcomas involving vascular structures can be treated selectively with tumor and vessel resection without the need for vascular reconstruction if distal limb perfusion is detected intraoperatively.

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“…3,13,14 Nevertheless, arterial occlusions during the neonatal and infantile period can result in catastrophic events. 3,[15][16][17] Following the arterial catheterization, infants might exhibit distal ischemia, 3 tissue necrosis, 3 pseudoaneurysms 13 or localized bleedings, 3 similar to adults. Moreover, infants might also encounter problems, such as discrepancies in growth and development in one of their extremities, unlike the adults.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, infants might also encounter problems, such as discrepancies in growth and development in one of their extremities, unlike the adults. 3,18 The most common cause of arterial injury in infants is iatrogenic. 3 Iatrogenic artery injuries mostly include direct arterial punctures, diagnostic and therapeutic cardiac catheterization and incorrect intra-arterial injections.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Conventional medical treatment methods used after arterial injuries during neonatal and infantile periods include the use of heparin, thrombolytic infusions and treatments such as surgical embolectomy, which can be carried out when necessary. [3][4][5][6][7] Despite conservative treatments, if the spasm in the arterial cannulation cannot be relaxed, in some patients extremity ischemia may continue and surgery becomes inevitable.…”

mentioning

confidence: 99%

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Use of Microsurgery and Iloprost in the Infantile Arterial Injuries

İriz

Erer

Kula

et al. 2007

Circ J

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Background To evaluate the use and advantage of microsurgical intervention and intravenous iloprost administration in delayed infantile artery injuries. Methods and Results Four patients were followed up and treated in our clinic between June 2003 and June 2006 for infantile artery injuries and distal ischemia. The average age of the 4 infants (3 girls, 1 boy) was 134.7± 33.6 days. The reason for all of the artery injuries was iatrogenic. Tissue necrosis started in patches in 2 babies who were admitted at the 12 th hour after ischemia (19 th and 22 nd hours), and therefore the artery was repaired by microsurgery. Iloprost infusion was also used in addition to the conservative treatments. The other 2 patients were assessed before the first 12 h after distal ischemia and were treated by iloprost without any surgical intervention. None of the patients lost any tissue or extremities during the 9 months (average) follow-up time. One of our patients died following the ventricular septal defect repair at the 9 th month after a successful repair of artery. Discussion We believe that intravenous iloprost infusion is very effective in the treatment of distal ischemia when used in addition to the conservative treatment methods for artery injuries in infants. (Circ J 2007; 71: 554 -558)

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Treatment of acute neonatal vascular injuries—The utility of multiple interventions

Cited by 48 publications

References 18 publications

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Case Report: Common Femoral Artery Ligation after Sarcoma Resection in an Infant

Use of Microsurgery and Iloprost in the Infantile Arterial Injuries

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