Management of Combat Vascular Injuries Using Modern Imaging : Are We Getting Better?
Joint Authors
Ofer, Amos
Hoffman, Aaron
Nitecki, Samy S.
Karram, Tony
Engel, Ahuva
Source
Emergency Medicine International
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-01-10
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Vascular injuries often result in life threatening hemorrhage or limb loss.
When they present with a single entry or exit wound, surgery is immediately indicated.
With multiple injuries, however, imaging such as CTA is necessary for diagnosis and choice of treatment.
Methods.
For all combat-related vascular cases admitted to our medical center during the Lebanon wars in 1982 and 2006, we compiled and compared presenting signs and symptoms, means of diagnosis, treatments, and results.
Results.
126 patients with vascular injuries were admitted (87 in 1982, 39 in 2006).
90% were male; mean age of 29 years (range 20–53).
All injuries were accompanied by insult to soft tissue, bones, and viscera.
75% presented with injury to arteries in the extremities.
75% of these patients presented with limb ischemia, and 25% sustained massive blood loss.
Treatments included venous interposition graft, end-to-end anastomosis, venous patch, endovascular technique (only in 2006), and ligation/observation.
Complications included thrombosis and wound infections.
Mortality and amputations occurred only in 1982, and this may be attributed to the use of imaging, advanced technique, and shorter average time from injury to hospital (7 hours).
Conclusions.
We recommend CTA as the first line modality for diagnosis of vascular injuries, as its liberal use allowed for early and appropriate treatment.
Treatment outcomes improved with fast and effective resuscitation, liberal use of tourniquets and fasciotomies, and meticulous treatment by a multidisciplinary team.
American Psychological Association (APA)
Nitecki, Samy S.& Karram, Tony& Ofer, Amos& Engel, Ahuva& Hoffman, Aaron. 2013. Management of Combat Vascular Injuries Using Modern Imaging : Are We Getting Better?. Emergency Medicine International،Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-490736
Modern Language Association (MLA)
Nitecki, Samy S.…[et al.]. Management of Combat Vascular Injuries Using Modern Imaging : Are We Getting Better?. Emergency Medicine International No. 2013 (2013), pp.1-6.
https://search.emarefa.net/detail/BIM-490736
American Medical Association (AMA)
Nitecki, Samy S.& Karram, Tony& Ofer, Amos& Engel, Ahuva& Hoffman, Aaron. Management of Combat Vascular Injuries Using Modern Imaging : Are We Getting Better?. Emergency Medicine International. 2013. Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-490736
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-490736