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. 1979 Jun;189(6):700–708. doi: 10.1097/00000658-197906000-00005

The surgical treatment of arterial injuries in the civilian population.

R R Reynolds, H A McDowell, A G Diethelm
PMCID: PMC1397245  PMID: 453941

Abstract

During an 8-year period, 191 consecutive patients were treated for arterial injuries. Blunt trauma occurred in 46 patients (24%), low velocity gunshot wounds in 82 patients (43%), shotgun wounds in 22 patients (12%), stab wounds in 20 patients (10%), iatrogenic injury in nine patients (5%), high velocity gunshot wounds in two patients (1%) and other penetrating wounds in ten patients (5%). Preoperative arteriography was performed in 48 patients (25%) who were hemodynamically stable with injuries to major vessels in the thorax, base of neck or extremities and in whom the exact location or extent of injury was unknown. Surgical repair was performed in 184 of 191 patients (96%); seven patients expired intraoperatively before reconstruction could take place. Repair was accomplished in the 184 patients by end-to-end primary anastomosis in 80 patients (44%), lateral sutures in 21 patients (11%), SVG in 71 patients (85%) and Dacron prosthesis in 13 patients (15%). One hundred seventy patients survived (89%) and 21 patients died (11%), seven of the 21 deaths were intraoperative and ten others were due to the effects of trauma to the aorta or its branches.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen T. W., Reul G. J., Morton J. R., Beall A. C., Jr Surgical management of aortic trauma. J Trauma. 1972 Oct;12(10):862–868. doi: 10.1097/00005373-197210000-00005. [DOI] [PubMed] [Google Scholar]
  2. Amato J. J., Vanecko R. M., Yao S. T., Weinberg M., Jr Emergency approach to the subclavian and innominate vessels. Ann Thorac Surg. 1969 Dec;8(6):537–541. doi: 10.1016/s0003-4975(10)66092-4. [DOI] [PubMed] [Google Scholar]
  3. Appelbaum A., Karp R. B., Kirklin J. W. Surgical treatment for closed thoracic aortic injuries. J Thorac Cardiovasc Surg. 1976 Mar;71(3):458–460. [PubMed] [Google Scholar]
  4. Billy L. J., Amato J. J., Rich N. M. Aortic injuries in Vietnam. Surgery. 1971 Sep;70(3):385–391. [PubMed] [Google Scholar]
  5. Bodily K., Perry J. F., Jr, Strate R. G., Fischer R. P. The salvageability of patients with post-traumatic rupture of the descending thoracic aorta in a primary trauma center. J Trauma. 1977 Oct;17(10):754–760. doi: 10.1097/00005373-197710000-00002. [DOI] [PubMed] [Google Scholar]
  6. Bole P. V., Purdy R. T., Munda R. T., Moallem S., Devanesan J., Clauss R. H. Civilian arterial injuries. Ann Surg. 1976 Jan;183(1):13–23. doi: 10.1097/00000658-197601000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Brawley R. K., Murray G. F., Crisler C., Cameron J. L. Management of woumds of the innominate, subclavian, and axillary blood vessels. Surg Gynecol Obstet. 1970 Dec;131(6):1130–1140. [PubMed] [Google Scholar]
  8. Bricker D. L., Noon G. P., Beall A. C., Jr, DeBakey M. E. Vascular injuries of the thoracic outlet. J Trauma. 1970 Jan;10(1):1–15. doi: 10.1097/00005373-197001000-00001. [DOI] [PubMed] [Google Scholar]
  9. Cheek R. C., Pope J. C., Smith H. F., Britt L. G., Pate J. W. Diagnosis and management of major vascular injuries: a review of 200 operative cases. Am Surg. 1975 Dec;41(12):755–760. [PubMed] [Google Scholar]
  10. Cohen C. A., Brief D., Mathewson C., Jr Carotid artery injuries. An analysis of eighty-five cases. Am J Surg. 1970 Aug;120(2):210–214. doi: 10.1016/s0002-9610(70)80113-1. [DOI] [PubMed] [Google Scholar]
  11. Debakey M. E., Simeone F. A. Battle Injuries of the Arteries in World War II : An Analysis of 2,471 Cases. Ann Surg. 1946 Apr;123(4):534–579. [PMC free article] [PubMed] [Google Scholar]
  12. Drapanas T., Hewitt R. L., Weichert R. F., 3rd, Smith A. D. Civilian vascular injuries: a critical appraisal of three decades of management. Ann Surg. 1970 Sep;172(3):351–360. doi: 10.1097/00000658-197009000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Flint L. M., Snyder W. H., Perry M. O., Shires G. T. Management of major vascular injuries in the base of the neck. An 11-year experience with 146 cases. Arch Surg. 1973 Apr;106(4):407–413. doi: 10.1001/archsurg.1973.01350160029005. [DOI] [PubMed] [Google Scholar]
  14. HUGHES C. W. Arterial repair during the Korean war. Ann Surg. 1958 Apr;147(4):555–561. [PMC free article] [PubMed] [Google Scholar]
  15. Hardy J. D., Raju S., Neely W. A., Berry D. W. Aortic and other arterial injuries. Ann Surg. 1975 May;181(5):640–653. doi: 10.1097/00000658-197505000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Hunt T. K., Blaisdell F. W., Okimoto J. Vascular injuries of the base of the neck. Arch Surg. 1969 May;98(5):586–590. doi: 10.1001/archsurg.1969.01340110078006. [DOI] [PubMed] [Google Scholar]
  17. MANSBERGER A. R., Jr, LINBERG E. J. FIRST RIB RESECTION FOR DISTAL EXPOSURE OF SUBCLAVIAN VESSELS. Surg Gynecol Obstet. 1965 Mar;120:579–579. [PubMed] [Google Scholar]
  18. PARMLEY L. F., MATTINGLY T. W., MANION W. C., JAHNKE E. J., Jr Nonpenetrating traumatic injury of the aorta. Circulation. 1958 Jun;17(6):1086–1101. doi: 10.1161/01.cir.17.6.1086. [DOI] [PubMed] [Google Scholar]
  19. PARMLEY L. F., MATTINGLY T. W., MANION W. C. Penetrating wounds of the heart and aorta. Circulation. 1958 May;17(5):953–973. doi: 10.1161/01.cir.17.5.953. [DOI] [PubMed] [Google Scholar]
  20. PATMAN R. D., POULOS E., SHIRES G. T. THE MANAGEMENT OF CIVILIAN ARTERIAL INJURIES. Surg Gynecol Obstet. 1964 Apr;118:725–738. [PubMed] [Google Scholar]
  21. Patman R. D., Thompson J. E. Fasciotomy in peripheral vascular surgery. Report of 164 patients. Arch Surg. 1970 Dec;101(6):663–672. doi: 10.1001/archsurg.1970.01340300019005. [DOI] [PubMed] [Google Scholar]
  22. Perry M. O., Thal E. R., Shires G. T. Management of arterial injuries. Ann Surg. 1971 Mar;173(3):403–408. doi: 10.1097/00000658-197103000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Pickard L. R., Mattox K. L., Espada R., Beall A. C., Jr, DeBakey M. E. Transection of the descending thoracic aorta secondary to blunt trauma. J Trauma. 1977 Oct;17(10):749–753. doi: 10.1097/00005373-197710000-00001. [DOI] [PubMed] [Google Scholar]
  24. Rich N. M., Baugh J. H., Hughes C. W. Acute arterial injuries in Vietnam: 1,000 cases. J Trauma. 1970 May;10(5):359–369. doi: 10.1097/00005373-197005000-00001. [DOI] [PubMed] [Google Scholar]
  25. Rich N. M., Hobson R. W., Jarstfer B. S., Geer T. M. Subclavian artery trauma. J Trauma. 1973 Jun;13(6):485–496. doi: 10.1097/00005373-197306000-00001. [DOI] [PubMed] [Google Scholar]
  26. Rich N. M., Metz C. W., Jr, Hutton J. E., Jr, Baugh J. H., Hughes C. W. Internal versus external fixation of fractures with concomitant vascular injuries in Vietnam. J Trauma. 1971 Jun;11(6):463–473. doi: 10.1097/00005373-197106000-00003. [DOI] [PubMed] [Google Scholar]
  27. Robbs J. V., Baker L. W. Major arterial trauma: review of experience with 267 injuries. Br J Surg. 1978 Aug;65(8):532–538. doi: 10.1002/bjs.1800650803. [DOI] [PubMed] [Google Scholar]
  28. SPENCER F. C., GREWE R. V. The management of arterial injuries in battle casualties. Ann Surg. 1955 Mar;141(3):304–313. doi: 10.1097/00000658-195503000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. STEENBURG R. W., RAVITCH M. M. Cervico-thoracic approach for subclavian vessel injury from compound fracture of the clavicle: considerations of subclavian-axillary exposures. Ann Surg. 1963 Jun;157:839–846. doi: 10.1097/00000658-196306000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Shumacker H. B., Jr Operative Exposure of the Blood Vessels in the Superior Anterior Mediastinum. Ann Surg. 1948 Mar;127(3):464–475. doi: 10.1097/00000658-194803000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Smith R. F., Elliot J. P., Hageman J. H., Szilagyi D. E., Xavier A. O. Acute penetrating arterial injuries of the neck and limbs. Arch Surg. 1974 Aug;109(2):198–205. doi: 10.1001/archsurg.1974.01360020060012. [DOI] [PubMed] [Google Scholar]
  32. Smith R. F., Szilagyi E., Elliott J. P., Jr Fracture of long bones with arterial injury due to blunt trauma. Principles of management. Arch Surg. 1969 Sep;99(3):315–324. doi: 10.1001/archsurg.1969.01340150023004. [DOI] [PubMed] [Google Scholar]
  33. Thal E. R., Snyder W. H., 3rd, Hays R. J., Perry M. O. Management of carotid artery injuries. Surgery. 1974 Dec;76(6):955–962. [PubMed] [Google Scholar]
  34. Yamada S., Kindt G. W., Youmans J. R. Carotid artery occlusion due to nonpenetrating injury. J Trauma. 1967 May;7(3):333–342. doi: 10.1097/00005373-196705000-00001. [DOI] [PubMed] [Google Scholar]

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