An observational cohort study of the management and outcomes of vascular trauma.
OBJECTIVE
To evaluate aetiology, presentation, management and mortality following iatrogenic and non-iatrogenic vascular trauma in a regional vascular centre.


METHODS
Retrospective observational cohort study of patients presenting with vascular trauma during a seven year period between January 2000 and December 2006.


RESULTS
182 cases of vascular trauma were identified (averaging 26 cases p.a.). The majority (n=132, 73%) were iatrogenic and tended to occur in patients aged >45 years, while 50 (27%) were penetrating/blunt, non-iatrogenic and predominantly occurred in younger males. The majority of iatrogenic vascular injuries (80/132) (61%) followed a cardiac intervention (angiography n=56, angioplasty n=23, pacemaker insertion n=1) and are now increasingly treated by non-operative therapies (thrombin, coils and covered stents). Overall, non-iatrogenic vascular trauma was associated with 4% mortality, compared with 7% following iatrogenic injury. However, while iatrogenic trauma of cardiological origin was associated with a mortality of only 1.3% (1/80), iatrogenic trauma of non-cardiological origin incurred a mortality of 17% (9/52).


CONCLUSIONS
The commonest cause of vascular trauma (and with the lowest mortality rate) was cardiological related iatrogenic injury. However, while non-cardiological iatrogenic injury occurred with the same incidence as penetrating/blunt trauma, it was associated with a fourfold excess mortality.
Bains
S K
SK
Department of Vascular and Endovascular Surgery, University Hospitals of Leicester, Leicester Royal Infirmary, Infirmary Square, Leicester, UK, LE1 5WW. salenabains@hotmail.com
Vlachou
P A
PA
Rayt
H S
HS
Dennis
M
M
Markose
G
G
Naylor
A R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001808:Blood Vessels / Q000293:injuries*; D002648:Child; D015331:Cohort Studies; D017023:Coronary Angiography / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000293:injuries; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000453:epidemiology; D055815:Young Adult