Vascular trauma

Abstract

Civilian vascular trauma is not uncommon. Prompt treatment with modern vascular surgical techniques produces good results.

Seat Belt Syndrome and Aortoiliac Lesion: Case Report and Review of the Literature

“…The associated aortoiliac trauma is rare due to the fact that iliac arteries are protected by the pelvis and retroperitoneal position [17,[22][23][24]. Among aortic blunt trauma, the thoracic location is much more frequent (95%) than the abdominal (0.05-0.08%) [9,15,25].…”

“…The extremity should be examined regarding to the temperature, color, expanding hematomas, bruits, pulses and neurological deficits. The most frequent finding is the absent or decreased pulse (52-96%) [15,16,23,29,30]. The seat belt sign, a lower abdominal contusion strip like a burn, is present in approximately 12% of the cases, associated with a high risk of intestinal lesions [29].…”

“…In spite of being the gold standard method for diagnosis, preoperative arteriography is contraindicated in the hemodynamically unstable patient with multiorganic injury. In the stable patient, however, arteriography should not be delayed because it will guide the diagnosis and treatment [15,16,23,[30][31][32][33]. Duplex Doppler ultrasonography, because of its fast and easy access, is useful in the diagnosis of penetrating and nonpenetrating vascular injuries [13].…”

“…Ligation of the iliac arteries, without revascularization, results in a lower limb amputation rate of 50% [13], being an alternative when there is irreversible ischemia of the extremity. Direct arterial repair is a good option when the lesions of the common iliac artery are smaller than 2 cm [23,34]. When the lesion is more extensive or direct repair is impracticable, the correction with graft interposition is mandatory.…”

“…Synthetic grafts are ideal for aortoiliac and aortobifemoral repairs, because of their easy manipulation and faster placement. When there is intestinal disruption and grossly peritoneal contamination, the use of prosthetic grafts is generally contraindicated [13,23,28]. In these cases, we should use autogenous grafts or artery ligation with extra-anatomical revascularization procedures [35].…”