由于诊断和治疗干预引起的医源性血管损伤(IVIs)是已知的,但很少见或报道不足。我们介绍了在资源有限的情况下进行血管外科修复的导管插入或手术后IVIs患者的四年发现。
■纳入了2018年6月至2022年9月之间的回顾性病例系列研究,其中35例确诊为IVIs并在我院接受手术治疗的患者。包括患者特征在内的IVIs数据,伤害的原因和类型,治疗,并对结局进行收集和分析.
■平均年龄为37.12±17.0岁,大多数患者(65.7%)为男性。在35个IVIs中,21是由经皮手术引起的,14例发生在术中并影响各种动脉和静脉。主要损伤血管是股动脉(20%),透析插管期间由不合格专家直接穿刺血管(42.9%)是主要原因。术中IVI累及下腔静脉3例,两个病人的主动脉,四髂外动脉,胫骨和pop动脉有四个,和颈内动脉合二为一。记录了以下类型的修复:有或没有动脉内膜切除术的血管直接缝合(71.4%),合成贴片放置(25.7%),结扎(8.6%),旁路或间置术(14.3%),和血栓栓塞切除术(5.7%)。32例(91.4%)患者血管修复成功,3例(8.6%)患者过期。7例(20%)患者出现并发症,其中浅表伤口感染是常见的并发症(11.6%),并采用适当的抗生素治疗。
■快速识别IVIs,以及未来治疗的适当分诊,可以提高患者的治疗效果。我们的数据显示,不合格的专家似乎对大多数IVIs负责。为此,我们强调由经过适当培训的合格专家进行血管手术的重要性。
UNASSIGNED: Iatrogenic vascular injuries (IVIs) due to diagnostic and therapeutic interventions are known but rare or probably under-reported. We present our four-year findings on patients with IVIs after catheterization or surgery who underwent vascular surgical repairs in a resource-limited setting.
UNASSIGNED: A retrospective case series
study between Jun 2018 and Sep 2022 of 35 patients diagnosed with IVIs and treated surgically at our hospital was included. The data on IVIs including patient characteristics, causes and type of injury, treatment, and outcomes were collected and analyzed.
UNASSIGNED: The mean age was 37.12± 17.0 years, and most patients (65.7%) were male. Of the 35 IVIs, 21 were caused by percutaneous procedures, while 14 occurred intraoperatively and affected various arteries and veins. The main injured vessels were the femoral artery (20%) and direct blood vessel puncture made by non-qualified specialists (42.9%) during dialysis cannulation was the main cause. The intraoperative IVI affected the inferior vena cava in three patients, the aorta in two patients, the external iliac artery in four, the tibial and popliteal arteries in four, and the internal carotid artery in one. The following types of repairs were recorded: direct suture of the vessel with or without endarterectomy (71.4%), synthetic patch placement (25.7%), ligation (8.6%), bypass or interposition graft (14.3%), and thromboembolectomy (5.7%). Vascular repair was successful in 32 (91.4%) patients while three patients (8.6%) were expired. Complications occurred in 7 (20%) patients, of which superficial wound infections were the common complication (11.6%) and were treated with proper antibiotic therapy.
UNASSIGNED: Prompt identification of IVIs, as well as proper triage for future treatment, can enhance patient outcomes. Our data showed that non-qualified specialists seem to be responsible for the majority of IVIs. For that, we emphasize the importance of performing vascular procedures by a qualified specialist with adequate training.