By Prof. Sven-Erik Bergentz, Ass. Prof. David Bergqvist (auth.)
This small yet information-packed booklet is the 1st to concentration solely on iatrogenic vascular accidents. it's a well timed first, for the scope and value of this topic have reached virtually epidemic proportions lately, because of exponential raises within the use of invasive diagnostic and healing techniques by means of virtually each clinical and surgical speciality. the information on vascular trauma from "civilian" studies have gotten ruled by way of accidents of iatrogenic reason. Even have been it now not for medical-legal legal responsibility, the significance of urged popularity and proper remedy of accidents that we ourselves reason is clear, as is the necessity for preventive measures to be in actual fact pointed out and followed. This publication serves those wishes good via a well balanced specialise in prevention, at the one hand, with its finished overview of epidemiology and etiology, and on administration, at the different, with its functional reviews on prognosis, remedy and end result. The association of this e-book makes it very usable. After chapters on either arterial and venous catheterization accidents, there follows a radical research of accidents linked to percutaneous transluminal angioplasty and different endovascular methods. Then, after a bankruptcy on noninvasive vascular accidents, there follows a sequence of chapters facing vascular accidents linked to the perform of particular specialties: radiation remedy, orthopedics, neurosurgery (especially lumbar disc surgery), gynecology, head and neck surgical procedure, urology, grownup common surgical procedure, and pediatric surgery.
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Of studies 4 16 1 3 1 1 8 15 1 16 4 5 Drug treatment Long-term treatment No treatment Not stated ASA ASA + dipyridamole Anticoagulants Different methods and combinations Duration of treatment (months) Not stated <3 months 3-6 months >6 months No treatment No. 8%. With an increasing number of publications there is no indication that a lower frequency of complications is reported. In a recent series, Cambria et al. 5% of which were considered major. Technical complications detected with radiology have only rarely been mentioned, but Weibull et al.
A fatal case was reported by Takolander et al. (1985). This was a patient who was first dilated because of a leftsided iliac stenosis; the intention was to advance the catheter, turn it around the aortic bifurcation, and advance it down into the right iliac artery for PTA on that side. After this maneuver the aorta occluded, with thrombus progression to the 44 Vascular Injuries After Percutaneous Transluminal Angioplasty a b c Fig. 6. a Fibromuscular dysplasia in a young female patient. b During dilatation the patient developed severe back pain and shock.
Injuries due to guide-wire and/or catheter manipulation may take the form of subintimal dissection, spasm, acute occlusion, or arteriovenous fistula. At the dilatation site there may be an arterial rupture, a pseudoaneurysm, a balloon rupture, or an occlusion. Finally, there may be distal complications, such as peripheral embolism. Injuries caused by contrast media will not be further discussed in this context, nor will septic complications be analyzed. Causes of Injury Complications at Puncture Site Hematoma at the puncture site after withdrawal of the catheter is a normal consequence of catheterization, although it is usually small and insignificant (Athanasoulis 1980; Laerum et al.
Iatrogenic Vascular Injuries by Prof. Sven-Erik Bergentz, Ass. Prof. David Bergqvist (auth.)