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BACKGROUND: Military vascular injuries frequently result from fragment wounds while civilian vascular injuries usually are caused by gunshot wounds. The natural history of untreated major injuries by small low velocity fragments is not well known. This study evaluated the nature of these wounds. METHODS: From 1990 to 1995, 40 patients with a delayed diagnosis of an arterial injury in the extremity, abdomen, or neck were treated. The median delay between injury and diagnosis was 60 days. All patients had been seen at other military hospitals immediately after trauma. RESULTS: During initial hospitalization, immediate exploration had been performed in 23 patients and arteriogram in 3 patients. According to analysis of the records of patients, none of them had hard signs of vascular injury at the time of initial evaluation after trauma. Complications of missed arterial injuries included the following: false aneurysm, 21 (52.5%); arteriovenous fistula, 14 (35%); and occlusion, 5 (12.5%). The superficial femoral artery (n = 11) was the most commonly injured vessel. The remaining arteries included the following: carotid, 2; vertebral, 1; subclavian, 5; axillary, 2; brachial, 3; radial or ulnar, 2; internal iliac, 2; common femoral, 1; profunda femoris, 2; popliteal, 1; tibioperoneal, 8. Thirty-eight patients had penetrating wounds (21 fragments, 9 gunshot, 3 shotgun, 5 stab wounds), and only 2 patients had blunt trauma. All patients underwent surgery. There were no deaths and no loss of extremity, but 10 patients had fair results and only 4 patients required later reoperation. CONCLUSION: Traumatic arterial injuries that particularly are caused by low-velocity small fragment wounds can result in serious delayed complications months or even years after the injury. Patients with penetrating injuries must be closely monitored, and arteriography is recommended to evaluate the conditions of patients with potential vascular injury even when overt clinical signs or symptoms of vascular injury are absent. Am J Surg. 1997;173:110-114. [C] 1997 by Excerpta Medica, Inc.

Aim: Temporary cessation of proximal blood flow is obligatory during surgery of peripheral arteries. We investigated usableness and results of using Fogarty catheter balloon for proksimal arterial bleeding control. Method: The study group consisted of the patients referred for peripheral artery surgery between January 2001 and May 2006. Group-I contained 38 patients who had stab, gunshot wounds or peripheral arterial lesions in which Fogarty catheter was used during surgery. The group II included same age and gender matched 40 patients who had been performed traditional methods for control of bleeding. Postoperative complication rates were collected from the patient files retrospectively. Result: Among the patients in group-II, there were lymphore in 5 patients (12.5%) p=0.034 and pseudoaneurysm in 5 patients (12.5%) p=0.034. Haematoma in 3 patients (7.89%) was common findings in group-I. Conclusion: Advancing a Fogarty catheter through percutaneous jugular vein introducer sheath is a safe, easy and time saving way of controlling proximal bleeding. Keywords: Bleeding control, Fogarty catheter, juguler introducer, lymphore, Table of Contents Abstract Introduction Material And Method Results Discussion References Introduction It is necessary to control the proximal arterial bleeding during surgery on distal peripheral arterial bed. The blood [...]

Table of Contents Abstract Introduction Case Report Discussion Conclusion References Abstract We present a case of a 19-year-old male with a stab wound localized at the junction of the left [...]

Table of Contents Abstract Introduction Surgical Technique Discussion References Abstract Arterial cannulation is sometimes more difficult in adult patients due to a highly positioned ascending aorta in the classical T-shaped [...]