TRAUMA IN DIFFERENT ARTERIAL BASINS – EPIDEMIOLOGY, LOCALIZATION AND TYPE FOR THE PERIOD OF 2020

Authors

  • Bogomila Chesmedzhieva UMHAT St.George, Plovdiv, Clinic of Vascular Surgery, Bulgaria
  • Stefan Stanev UMHAT St.George, Plovdiv, Clinic of Vascular Surgery, Bulgaria

Keywords:

Arterial trauma, traumatic agent, arterial trauma localization

Abstract

Extremity trauma, affecting magistral arteries are among the main reasons for extremity disfunction or amputation in patients in young age. Massive bleeding, caused by arterial wall damage can lead to systemic shock, multiorgan failure  and death. Main priority in cases of severe trauma are life preserving actions – hemostasis and adequate resuscitation sometimes for the price of limb loss. According to the different researches the main causes for arterial traumatism are car accidents, stab wounds of various genesis, lacerations, blunt trauma, gunshot wounds. Our review of the literature references shows large differences in the type of traumatic agent in the different populations.

Aim: Researching the demographic specifications, type of the traumatic agent and the trauma, affected arterial basin, incidence and type of postoperative complications.

Materials and methods: The research is retrospective, conducted in the period 01.01.2020-31.12.2020. The patients included are with reconstructable vascular trauma. Exclusion criteria: iatrogenic trauma, patients with adequate collateral perfusion and ligation of affected arterial vessel, patients assessed for primary amputation.

Results: 23 patients  aged between 4 to 68 years met the criteria, middle age 41,61y, std. deviation 17,42y. Twenty one (91,3%) of the patients were male, 2 (8,7%) were female. According to type of trauma – cut(stab) wound  (56,5%); lacerated wound  7 (30,4%); concuasations - 2 (8,7%); gunshot wound – 1 (4,3%). In 13 (56,5%) of the cases right limb was affected, and in 10 (43,5%) left. In  most of the cases we discovered arterial trauma of the forearm 17 (73,9%), followed by legs 5 (21,7%), in one case (4,3%) the arm was affected. According to the affected artery: radial artery13 (56,5%), isolated ulnar artery trauma 3 (13%); brachial artery – 2 (8,7%); superficial femoral artery – 2 (8,7%); posterior tibial artery – 2 (8,7%); anterior tibial artery – 1 (4,3%).  Seventeen (73,9% ) of the patients were discharged without complications, in 6 (26,1%)  rethrombosis or suppuration was verified.

Discussion: Although arterial trauma is only a fraction of vascular surgery interventions (1,7 of interventions in our Clinic  for the year) it has major role in vascular surgery, because arterial trauma affects young people  and is a risk factor for invalidisation and death.

Conclusion: According to the literature arterial trauma is more common in the events of war conflicts in peacetime domestic traumatism is becoming more frequent. The biggest challenge for the vascular surgeon is limb preservation (in most of the cases upper extremity). Even in the conditions of massive blood lose and poor patient condition at admission a major factor for saving the affected limb  is the time period form the trauma to the admission in vascular surgery ward.

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Published

2021-12-15

How to Cite

Chesmedzhieva, B., & Stanev, S. (2021). TRAUMA IN DIFFERENT ARTERIAL BASINS – EPIDEMIOLOGY, LOCALIZATION AND TYPE FOR THE PERIOD OF 2020. KNOWLEDGE - International Journal , 49(4), 775–778. Retrieved from https://ikm.mk/ojs/index.php/kij/article/view/4557