Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops

Dhillan, Rishi; Bhalla, Alok; Jha, Sushil K.; Singh, Hakam; Arora, Aman

doi:10.20408/jti.2018.032

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…The mortality rate in a study by Eslami et al on 3408 patients in the pediatric vascular injuries group was measured to be 7.9% [32]. Moreover, in a study by Dhillan et al in India, the mortality rate of vascular injuries was equal to 6.52% [51]. Furthermore, in a cohort and retrospective study by Sharrock et al, this rate was equal to 10% [52], i.e., approximately the same as the current research results.…”

Section: Discussionsupporting

confidence: 86%

“…In the present study, the most common causes of trauma included accident [48][49][50][51], fall [52], and create hit [53]. Garg et al conducted a research in India and concluded that 83.33% of patients had VT due to blunt trauma [48].…”

Section: Discussionmentioning

confidence: 97%

“…Besides, a study by Ramdass et al in India included 9 (28%) cases [50]. A study by Dhillan et al included 3 (8.33%) cases [51]. However, in a study by Van Dongen et al in the Afghan war injury group, the initial amputation rate was reported as 77.4% [53], which can be among the causes of trauma.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Vascular Trauma and Related Factors in Iran: A Systematic Review

Karimian

Okhli

Noormohammadi-Dehbalaee

et al. 2021

IJMTFM

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Background: Managing patients with Vascular Trauma (VT) is essential. This study aimed to determine the prevalence of VT and its related factors in Iran. Methods: This systematic review was performed by two skilled researchers. To access all the Persian and English articles on VT and its influencing factors (from 2000 to August 2019), in addition to Google Scholar search engine, other international databases, such as PubMed/ Medline, Scopus, Embase, Cochrane Library, Science Direct, Web of Science (ISI), and domestic databases, such as Magiran, IranDoc, National Library of Iran Organization, SID, and Barakatkns were used. Data analysis was conducted by MA (CMA) software. Results: The incidence of lower Lower Vascular Trauma (LVI) trauma was equal to 58.4 (95%CI: 41.1-73.8) (I2= 94.67, Q=112.57, P<0.001); the prevalence of upper LVI trauma was measured to be 31.5 (95%CI: 17.7-49.7) (I2=94.48, Q=108.70, P<0.001); the prevalence of penetrating trauma was calculated as 61.3 (95% CI: 49.5-71.9); the prevalence of ulnar nerve injury equaled 9.8 (95%CI: 2.8-28.6); the prevalence of radial nerve trauma was equal to 7.7 (95%CI: 1.2-35.4); the prevalence of death cases was reported as 12.3 (95%CI: 5.1-26.9); the prevalence of amputation rate was observed as 8.8 (95%CI: 5.7-13.4); the prevalence of fasciotomy rate was equal to 22.2 (95%CI: 13.2-34.5); the prevalence of complete artery cutting equaled 55.7 (95% CI: 35.4-74.3),and the prevalence of incomplete artery cutting was measured as 25.5 (95%CI: 12.1-45.9). Conclusion: According to the study results, VT has led to various complications in patients; thus, it is critical to provide the necessary conditions to preserve the patient’s life and prevent life-threatening complications. Such goals could be achieved by preventing this type of trauma and its related complications.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 97%

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Prevalence of Vascular Trauma and Related Factors in Iran: A Systematic Review

Karimian

Okhli

Noormohammadi-Dehbalaee

et al. 2021

IJMTFM

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“…Early diagnosis is the key to appropriate management of arterial and venous injuries. [10] Physical examination is critical in the diagnosis of patients with suspected vascular injuries. Mataraci et al [11] reported that early surgical intervention, extent and site of the trauma, and presence of concomitant injured structures in addition to vascular injuries were the most important factors affecting the morbidity and the mortality of the vascular trauma patients.…”

Section: Discussionmentioning

confidence: 99%

Our experiences with the surgical repair of traumatic vascular injuries

Halıcı¹

2020

Turk J Vasc Surg

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Objectives:The aim of this study is to report our experiences about the surgical repair of traumatic vascular injuries.Patients and methods: Between January 2011 and July 2019, 164 patients (151 males, 13 females; mean age 35.6±13.8 years; range, 6 to 77 years) who underwent emergency surgery due to vascular injuries were included in this retrospective study. Operative techniques, causes for injury, and patient outcomes were analyzed. Data were collected from the patient records.Results: Repair for major arterial injury was performed in 149 patients and 59 of them had a major venous injury. Of 149 patients, 18 had an only major arterial injury. Seven patients had an only major venous injury. Exploration and ligation of bleeding of the small arteries and veins were performed in eight patients. Primary repair with end-to-end anastomosis in 85 arterial and 20 venous injuries was performed. Autologous vein graft interpositioning was performed in 36 arterial and 16 venous injuries. Lateral wall repair was performed in nine arterial and eight venous injuries. Ligation was performed in 25 arterial and 20 venous injuries. An 8-mm biological graft interpositioning was performed to both popliteal artery and popliteal vein in one patient with a gunshot wound. Externally supported polytetrafluoroethylene synthetic graft interposition was performed in five arterial injuries. A 6-mm Dacron graft was placed in one patient. Thoracic endovascular aorta repair was performed in one patient with a descending thoracic aortic rupture. Conclusion:Peripheral vascular injuries should be kept in mind in trauma patients and detected vascular injuries should be repaired as soon as possible after a detailed vascular examination.

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Our experience with blast and gunshot induced traumatic vascular injuries at Somalia’s major vascular referral center

Hussein,

Ali,

Ahmed

et al. 2024

Sci Rep

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Blast and gunshot-induced penetrating traumatic vascular injuries represent a significant portion of patients with vascular trauma in countries where there are higher rates of war-related violence. These injuries are especially challenging in resource-limited countries due to early diagnosis and transfer delays. This report aimed to present our experience regarding the surgical management and outcome of such injuries at a major referral vascular surgery centre in the country. A retrospective descriptive review of 326 patients with blast and gunshot-induced penetrating traumatic vascular injuries managed during a five-year period between April 2018 and April 2023. The demographics, mechanism of injury, type of vascular injury, Anatomical location, time to the operation, length of hospital stay, amount of blood products given, concomitant neuroskeletal injuries, development of Vascular injury associated acute kidney injury, surgical procedures performed and patient outcome were reviewed. In this study, 326 patients with 445 vascular injuries fulfilled the inclusion criteria. Most of the patients were male 92.3%, and the mean age was 28.3 ± 9.9 years. The gunshot mechanism of vascular injury was implicated in 76.1% of the injuries, and explosive-induced injury was 78 (23.9%). 193 (59.2%) of the patients had isolated arterial injuries, 117 (35.9%) patients had combined arterial and venous injuries while 18 (4.9%) patients had isolated venous injuries. The most commonly injured arteries were the femoral artery, followed by Brachial and popliteal artery injuries (26.1%, 23.5% and 19.4%, respectively). The median time to revascularization was 8.8 ± 8.7 h. 46.8% of the patients had Concomitant fractures, while 26.5% had Concomitant nerve injuries. Only three patients had temporary non-heparin-bound shunts during their arrival. The most common surgical intervention in arterial injuries was reversed saphenous vein graft 46.1%. The mortality was 5.8% and 7.7% of the patients needed secondary amputation. The majority of wartime arterial injuries are a result of Blast and gunshot vascular injuries. Frequent need for autologous vein grafts should be considered to manage such injuries. Results are encouraging despite delays in intervention; therefore, all viable limbs should be revascularized, keeping in mind the long-term functionality of the limb.

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Vascular Injuries Due to Penetrating Missile Trauma in Anti-Terrorism Ops

Cited by 4 publications

References 13 publications

Prevalence of Vascular Trauma and Related Factors in Iran: A Systematic Review

Prevalence of Vascular Trauma and Related Factors in Iran: A Systematic Review

Our experiences with the surgical repair of traumatic vascular injuries

Our experience with blast and gunshot induced traumatic vascular injuries at Somalia’s major vascular referral center

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