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Vascular Trauma

Featured Article: Management of Exsanguinating Pelvis Injuries

Severe pelvic injuries associated with disruption of pelvic vasculature carry an extremely high mortality.  A directed approach to management can significantly improve survival in this critical patient group.

Featured Case Study: Bilateral lower extremity gunshot wound with arterial and venous injury

20 years old man after civilian gunshot wound, arrived in our emergency department with profound shock and ongoing bleeding from gunshot wounds to both thighs.

Featured Images

  • Vascular Damage Control 2

    Saphenous vein grafts to femoral artery & vein injuries

    Luis Filipe Pinheiro, Hospital São Teotónio-Viseu, Portugal

  • Vascular Damage Control 1

    Vascular shunts in femoral artery & vein

    Luis Filipe Pinheiro, Hospital São Teotónio-Viseu, Portugal


  • Gunshot left carotid artery - angiogram - lateral 01

    Carotid angiogram showing disruption of external and internal carotid arteries

    Herb Phelan, Brian Eastridge, Parkland Memorial Hospital, Dallas, Texas


  • Gunshot wound to carotid artery - operative - 03

    Herb Phelan, Brian Eastridge, Parkland Memorial Hospital, Dallas, Texas


Recent Images

  • Pelvic fracture causing hypovolaemic shock

    An AP radiograph of the pelvis showing bilateral fractures of the superior and inferior pubic rami and a fracture of the right femoral greater trochanter.

    Dr B. Hanterdsith

  • Gunshot injury to the right subclavian artery

    Injury to the right subclavian artery at time of operation

    Dr B. Juan Zuniga, Dr P. Cesar Benitez, Dr A Jessenia Dumani - Cardiothoracic Surgery Team, Hospital Luis Vernaza JBG Guayaquil - Ecuador


  • External iliac artery damage control surgery

    18-Fr nasogastric tube shunt across left external iliac artery lesion

    Michael Fernandes, Hospital Risoleta Tolentino Neves, Belo Horizonte-MG, Brasil


  • Vascular damage control via a shunt

    SFA and SFV shunts for damage control of a penetrating knife injury

    Dr D Allard, Trauma Surgeon, GF Jooste Hospital, Cape Town, South Africa


  • Axillary artery injury from blunt trauma

    Left shoulder at time of admission

    Dr. Setthabutr Eaupanitcharoen, M.D. Trauma Division, Department of surgery, Maharat Nakornratchasima hospital, Nakornratchasima Thailand

  • Traumatic amputation of the hand

    Traumatic amputation of the hand

    Gabriel Mejia Consuelos, MD. SF-ACS-COT. Hospital General Balbuena. Mexico City



All Images in This Category »

Article List

Management of Exsanguinating Pelvis Injuries

An algorithm for the management of exsanguinating pelvic trauma

Karim Brohi, London, UK, May 20, 2008

Severe pelvic injuries associated with disruption of pelvic vasculature carry an extremely high mortality.  A directed approach to management can significantly improve survival in this critical patient group.

Patch Angioplasty

, Stanford University, October 15, 2005

Patch angioplasty is used to repair a partial disruption of a vessel wall or longitudinal incision, where simple suture would result in narrowing of the vessel. The arteriotomy below was made in the common femoral artery as part of a procedure to remove clot from the external iliac artery

Combined Vascular & Skeletal Trauma

, Stanford University, October 07, 2005

Eric Frykberg discusses the management of these complex injuries.

Extraperitoneal Approach to the Iliac Vessels

, December 07, 2002

Patch Angioplasty

, December 02, 2002

Penetrating Neck Injury

, June 07, 2002

Peripheral Vascular Trauma

, March 07, 2002

Elastic nailing of paediatric forearm fractures

, February 07, 2002

Case Presentations

Anal Necrosis Following Pelvic Crush Injury

John S.Berry MD, Alfred F. Trappey MD, Joseph L. Petfield MD, Julia M. Greene MD, Katherine Markell MD

Julia Greene, November 28, 2012

Arterial haemorrhage within the pelvic circulation can be controlled by nonselective embolization. However, complications are associated with distal ischemia from disruption of the aortoiliac circulation. Reported complications of pelvic crush injury include impotence, lower extremity nerve deficits, left colon ischemia, spinal cord injury, and necrosis of the rectum and gluteal musculature. We report a case of anal canal necrosis after a pelvic crush injury attributed to hypotension, compression by pelvic hematoma, and arterial disruption after selective unilateral transcatheter arterial embolization (TAE).

Post traumatic intraorbital arteriovenous fistula

payman Moharamzadeh, Tabriz University of Medical Sciences-Imam Reza Ho, August 04, 2011

A patient with a history of previous closed head injury presented with chemosis, proptosis and conjunctival injection of the right eye. CT showed a dilated superior ophthalmic vein suggesting the presence of a carotid–cavernous sinus fistula.

Bilateral lower extremity gunshot wound with arterial and venous injury

Gunshot injury to both lower limbs requiring vascular damage control

sam zeraatian nejad davani, December 26, 2010

20 years old man after civilian gunshot wound, arrived in our emergency department with profound shock and ongoing bleeding from gunshot wounds to both thighs.

Aortic Dissection in Blunt Trauma

Tiffany Frederickson, MD, August 21, 2010

A patient involved in a car accident causing his vehicle to roll, sustained an aortic dissection just distal to the renal arteries requiring open aortic grafting to repair it.

Venous laceration to lower limb without fasciotomy

Shunting superficial femoral vein to avoid fasciotomy

Denis Allard, GF Jooste hospital Manenberg, August 04, 2009

Trauma surgeons deal rarely with isolated penetrating venous injuries to the lower limbs due to the proximity of the vein-arterial complex. The limb remains vascularized but intensely swollen and a fasciotomy must be considered. Inserting a 'drip line' into both severed ends permits immediate venous return and improves the venous hypertension to the point where a fasciotomy can be avoided. This 'damage control' act does allow one to come back a day later and to reestablish continuity with any interposition graft available. The contralateral long saphenous is first choice, a synthetic graft second, a ligature and fasciotomy third choice.

Gunshot to Carotid Artery

Gunshot carotid artery: angiogram & vein graft repair

Herb Phelan, Parkland Memorial Hospital, Dallas, TX, USA, July 10, 2007

A gunshot wound to the left neck, disrupting the internal and external carotid arteries.  Operative repair with reversed vein graft.

Superficial Femoral Artery Impalement.  Arterial Shunt

Demonstrating the utility of an arterial shunt prior to definitive repair.

Karim Brohi, London, UK, January 08, 2007

A combined femur fracture and superficial femoral artery impalement injury managed with temporary shunting to restore flow before fracture fixation and definitive repair.

Angiographic Coiling for Pelvic Haemorrhage

Classic Case

, November 28, 2006

Infrahepatic Inferior Vena Cava injury

Lateral repair

, October 16, 2005

Gunshot wound to the abdomen, with injury to the lateral wall of the infrahepatic inferior vena cava.  The IVC was accessed through a right medial visceral rotation and a lateral repair performed.

Research Blog Entries

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