Iatrogenic vascular injuries

Abstract

We are providing here a retrospective evaluation of vascular injuries occuring due to iatrogenic reasons and the surgical operations performed in the treatment. Surgical operations were performed on 52 cases with iatrogenic vascular injuries between 1984-2004 at our cardiovascular surgery clinic. The patients included 33 males and 19 females, with a mean age of 52. Vascular injury occured at 45 patients during cardiac catheterization and angiography attempts, at 4 patients during peripheric angiography and at 3 patients during femoral arterial canulation attemps. Vascular injury led to thrombosis at 29 cases, ruptur and hematoma at 18 cases, pseudoaneurysm at 2 cases and LAD (Left anterior descending) artery at 2 cases and circumflex (Cx) artery at 1 case. Embolectomy was performed on 28 cases, drenage of hematoma and primary repair of the vessel was performed on 14 cases, excision of pseudoaneurysm on 2 cases, LAD artery and Cx artery repair in 3 cases, femora-femoral bypass from left to right at 3 cases, and iliofemoral bypass operation was performed at 2 cases. Cardiac catheterization and angiography attempt was the precedure leading to the highest rate of injuries (86.53%). Right femoral arterial was most prone to injuries. Amputation were performed on 3 patients, 2 of these were at the top of the knee and 1 was total hip desarticulation (5.7%). The rest of the patients fully recovered. Iatrogenic vascular injuries are important surgical matters requiring early detection and treatment. This is the only way of achieving reduced mortality and morbidity.