Tag Archives: ιατρογενή αρτηριακά τραύματα

Iatrogenic and Noniatrogenic Arterial Trauma: A Comparative Study – Commentary

28 Σεπτεμβρίου, 2012

Δεν επιτρέπεται σχολιασμός στο Iatrogenic and Noniatrogenic Arterial Trauma: A Comparative Study – Commentary

Συντάχθηκε από:

Αναστάσιος Λιάτας, MD, F.I.C.A. – Διευθυντής Χειρουργός

A C Liatas, MD, F.I.C.A. – Consultant Surgeon

Athens  General  Hospital  » EVAGELISMOS «

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Iatrogenic and Noniatrogenic Arterial Trauma

Purpose of study

This study compared patients with iatrogenic and noniatrogenic arterial injuries.

Conclusion

Retrospective assessment of the appropriateness of technique, made separately by two vascular surgeons, revealed instances of potentially avoidable iatrogenic arterial injury. The increasing incidence of iatrogenic arterial trauma may therefore be considered reducible.

Commentary

The paper states the expected conclusions: that iatrogenic injuries increase with the incidence of invasive procedures, that such injuries are nearly always related to the catheterization site and that in them thrombosis is a more frequent complication than hemorrhage. The noniatrogenic injuries (blunt trauma, motor vehicle accident and knife and gun injuries) had a predictably higher rate of associated and postoperative complications. The 14% mortality rate reported in the iatrogenic group is nearly 4-10 fold that reported in larger reviews. These results may be biased by the relatively few cases included in this report. – Ramon Berguer; Detroit

Δημοσίευση Άρθρου

Το πλήρες άρθρο έχει δημοσιευτεί στο:  [International Vascular Surgery 1991; 1:92-93]

Αρχείο Άρθρου

Για το πλήρες άρθρο «Iatrogenic and Noniatrogenic Arterial Trauma…» πατήστε:  Εδώ (.pdf αρχείο).

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Iatrogenic and noniatrogenic arterial trauma – a comparative study

15 Σεπτεμβρίου, 2012

Δεν επιτρέπεται σχολιασμός στο Iatrogenic and noniatrogenic arterial trauma – a comparative study

Συντάχθηκε από:

Αναστάσιος Λιάτας, MD, F.I.C.A. – Διευθυντής Χειρουργός

A C Liatas, MD, F.I.C.A. – Consultant Surgeon

Athens  General  Hospital  » EVAGELISMOS «

1

2

Iatrogenic and Noniatrogenic Arterial Trauma

Introduction

Iatrogenic arterial trauma may arise in diagnostic or therapeutic  procedures   (Gr.   ἰατρός  =  physician, γεννώ = give birth to). The incidence of reported iatrogenic  arterial  trauma  has  clearly risen in recent years, as a result of the dramatically increased performance  of  cardiac  catheterization  and angiography, or of the increasingly  radical  operations now performed for a variety of lesions in all surgical fields.

Purpose of study

This study compared patients with iatrogenic and noniatrogenic arterial injuries.

Discussion

Although iatrogenic arterial trauma is a well defined clinical entity, its reported incidence in relation to total numbers of arterial injuries varies from 1.4% to 76% . In our study, 34% of the arterial injuries were iatrogenic. As some cases of iatrogenic arterial injury are not reported for fear of legal consequences, no clear picture of the problem’s size is obtainable.
The arteries of the extremities most often affected were brachial and femoral, the commonest sites of arterial puncture in the iatrogenic group, and leg arteries were mostly injured in noniatrogenic group. Orthopaedic and general surgery were responsible for most iatrogenic injuries. Haemorrhage, presenting either as an arterial bleed or as an expanding haematoma, occurred in 28 of our 43 non iatrogenic arterial injuries, but in only four of the 22 in the iatrogenic group (p < 0.001). The patients in that group presented mainly with severe or mild ischaemia.
The postoperative mortality rate did not differ significantly between iatrogenic and noniatrogenic group, which accords with previously reported corresponding rates of 10% and 15 % . Other authors found 4 %  or 1.7%  mortality in their series of iatrogenic vascular injury, compared with 14 % in our series.
Factors of two types have been implicated in iatrogenic vascular injury, viz. doctor-related (inadequate knowledge, inefficient anatomic dissection or traumatic or faulty technique) and patient-related (inflammation, tumour, irradiation, reoperation, anatomic variations). Most of them are related to arterial catheterization performed mainly by nonsurgeons.

Conclusion

As iatrogenic arterial injuries may occur even in the most capable hands, they must be recognized and adequately corrected so as to reduce the risk of incapacitating sequelae.

Δημοσίευση του Άρθρου

Το πλήρες άρθρο έχει δημοσιευτεί στο: [ Eur J Surg 1991; 157:17-20 ]

Αρχείου του Άρθρου

Για το πλήρες άρθρο «Iatrogenic and Noniatrogenic Arterial Trauma: a comparative study» πατήστε: Εδώ  (.pdf αρχείο).
Continue reading...