医源性血管损伤的单中心5年经验及其结果

IF 0.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
A. Dabas, Anand Katiyar, Sachin Srivastava, A. Chadha, R. Janardhanapillai, K. Bhat, D. Chadha
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引用次数: 1

摘要

引言:诊断和治疗干预可能导致医源性血管损伤。介绍了IVI的范围、管理和结果。材料和方法:这项2016年1月至2020年12月的前瞻性观察性研究包括血管外科管理的所有连续IVI。IVI被定义为血管损伤,表现为出血/血管闭塞/和/或血管系统中残留异物。那些由于创伤和/或随访<30天的患者被排除在外。分析IVI的原因、表现、涉及的血管和结果。结果:对38例IVI进行了分析。年龄3天至77岁。16例死于心脏病学,7例死于骨科,4例死于终末期肾脏患者,4例因侵入性动脉监测,2例死于心脏手术。腹腔镜、脊柱手术、血栓切除术、血管内动脉瘤修复术和脐带导管插入术各1例。表现为肢体缺血(下肢-13,上肢-6)、假性动脉瘤-10、滞留异物-4(上腔静脉和/或右心房-3;髂外动脉-1)、出血-2、动静脉瘘-2和隔室综合征-1。股总动脉(有/无股浅动脉)受累13例,前臂动脉受累8例,腘动脉和脚动脉各受累3例,股深部、颈动脉、髂外动脉支和胸主动脉各受累1例。IVI通过血栓切除术治疗13例,动脉修复术治疗11例,血管内手术治疗5例,搭桥术治疗4例,保守性手术治疗3例,剖腹手术和球囊开放式取出各1例。4人出现手术部位感染,3人死亡,3人截肢,3人运动功能障碍,2人急性肾损伤。结论:IVI具有异质性表现。管理需要开放式和血管内技能。IVI具有较高的发病率和死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A single-center 5-year experience of iatrogenic vascular injuries and their outcomes
Introduction: Diagnostic and therapeutic interventions can lead to iatrogenic vascular injuries (IVIs). The spectrum of IVIs, their management, and outcomes is presented. Materials and Methods: This prospective observational study from January 2016 to December 2020, included all successive IVIs managed by the vascular surgery department. IVI was defined as vascular injury manifesting as hemorrhage/vessel occlusion/and/or retained foreign body in vasculature. Those due to trauma and/or <30 days follow-up were excluded. Reasons for IVI, presentation, vessels involved, and outcomes were analyzed. Results: Thirty-eight IVIs were analyzed. Age ranged from 3 days to 77 years. Sixteen were due to cardiology, seven due to orthopedics, four cases in end-stage kidney patients, 4 cases due to invasive arterial monitoring, and two following cardiac surgery. One case each was following laparoscopy, spine surgery, thrombectomy, endovascular aneurysm repair, and umbilical catheterization. Manifestations were limb ischemia (lower limb-13, upper limb-6), pseudoaneurysms-10, retained foreign body-4 (superior vena cava and/or right atrium-3; external iliac artery-1), hemorrhage-2, arterio-venous fistula-2, and compartment syndrome-1. Common femoral artery (with/without superficial femoral artery) was affected in 13, forearm arteries in 8, popliteal artery and crural arteries in three each, and one case, each of profunda femoris, carotid artery, external iliac artery branch, and thoracic aorta. IVIs were managed by thrombectomy in 13, arterial repair in 11, endovascular procedures in 5, bypass in 4, conservative in 3, and by laparotomy and open retrieval of a balloon in one case each. Four developed surgical site infections, three died, three suffered amputations, three had motor deficits, and two developed acute kidney injury. Conclusion: IVIs have heterogeneous presentation. Both open and endovascular skill sets are required for management. IVIs carry high morbidity and mortality.
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