Vascular Trauma in Infants and Children

A review of vascular surgery in the pediatric population

“…In addition, a large percentage of penetrating traumas made up the study population, which is typically associated with less systemic injury. It is likely that survival of central vascular injuries is much lower than reported, which is supported in studies that report lower survival for children when compared to adults with central vessel injuries [1,[5][6][7]. It has been suggested that outcome may be affected by treatment of pediatric trauma patients at trauma centers of adult hospitals, and children should therefore be transported to tertiary pediatric centers after stablization [4].…”

“…Central vascular injury The central vascular system is an uncommon location of injury, associated with high mortality [1][2][3]. More contemporary experience reported in a recent series documented over two-thirds of patients surviving after central vascular trauma [4].…”

“…The remaining vascular tree is adequately managed with adequate proximal and distal control transiently occluding flow to allow for repair. After control, the preferred method of repair has been primary closure of the defect or segmental resection, with the use of autologous graft or synthetic material when extensive injury makes the former options infeasible [1,2,4].…”

“…Many authors recommend early operative intervention after development of signs of acute ischemia or absence of femoral pulse [1,22,[49][50][51]. However, others feel that non-operative management should be considered [43,52,53].…”

Arterial Injuries in Children

“…The main indications for this procedure are as follows. Extremity gunshot wounds 4 Since the majority of patients with loss of peripheral pulses or gunshot wounds had positive physical findings, the addition of an arteriogram probably was not necessary in many instances.…”