Thoracic aortic transection (TAT) is the second commonest cause of death from blunt trauma surpassed only by head injury and is associated with a mortality of 80% to 90%. The injury site is typically anteromedial at the aortic isthmus where differential shear forces act during rapid deceleration. The authors report ...

Pelvic fractures secondary to blunt trauma are associated with a significant mortality rate due to uncontrolled bleeding. Interventional radiology (IR) can play an important and central role in the management of such patients, offering definitive minimally invasive therapy and avoiding the need for high-risk surgery. Rapid access to whole-body computed ...

OBJECTIVES: The purpose of this study was to investigate the efficiency of small interfering ribonucleic acid (siRNA) in murine arteries. We transfected it using a nonviral ultrasound-microbubble-mediated in vivo gene delivery system. BACKGROUND: siRNA is an effective methodology to suppress gene function. The siRNA can be synthesized easily; however, a ...

Background: Hemorrhage from wounds in the extremities is the leading cause of preventable death on the battlefield. To successfully treat these injuries, the exact source of bleeding must be localized. Objective: The purpose of this study was to determine the feasibility of using Doppler ultrasound to precisely detect and localize ...

STUDY DESIGN: Case study. OBJECTIVE: To emphasize the role that interventional radiology can perform in stemming bleeding to vascular structures injured during spine surgery without altering patient position. SUMMARY AND BACKGROUND DATA: Injury to the lumbar artery or aorta may occur during lumbar disc surgery. Occasionally the site of bleeding ...

Vascular complications following trans-sphenoidal surgery can occur due to injury of the cavernous segment of the internal carotid artery, external carotid artery and its branches or an aneurysm rupture. The incidence of vascular complications in trans-sphenoidal surgery is 0.4% to 1.4%. Vascular injury was encountered in a patient with giant ...

A rare case of a big cat fatal attack is presented. A male leopard that had escaped from its unlocked cage attacked a 26-year-old male zoo worker. The man sustained penetrating injuries to the neck with consequent external bleeding. The man died while being transported to the hospital as a ...

To use the mice deficient in both adenosine receptor A(2A)(A(2A)R(-/-)) and apolipoprotein E (apoE(-/-)) to investigate the role of A(2A)R in mediating the interactions of leukocytes with injured arterial walls and the formation of arterial neointima induced by a guide wire. In apoE(-/-) mice, A(2A)R deficiency increased the size of ...

We describe a case of innovative endovascular techniques to repair traumatic bilateral axillary artery disruption. A 36-year-old male construction worker fell eight stories from a scaffold and sustained bilateral axillary artery injuries. The injuries between the brachial and axillary arteries were bridged using long bare self-expanding stents (Zilver). To the ...

We report a case of a patient who developed an aortic dissection with rupture. This presumably was a delayed injury following blunt thoracic trauma and highlights that concerns for aortic pathology even in this patient population.

BACKGROUND: Inadvertent cannulation or penetration of the cervical radicular arteries during cervical transformaminal epidural injections (TFESIs) is a serious clinical risk, and purportedly, the cause of possible spinal cord injury sustained during this procedure. CASE: Here, we present a case of inadvertent intravascular penetration of a cervical radicular artery during ...

Percutaneous iliosacral screws are considered the standard of care for disruptions of the sacroiliac joint. This article describes a case of iatrogenic injury to the superior gluteal artery during iliosacral screw insertion and analyzes the possible reasons for this complication.A 32-year-old man diagnosed with an unstable pelvic ring injury underwent ...

Blunt gallbladder injury is rare, and bleeding from the cystic artery due to blunt trauma is even rarer. We report herein a case of extraluminal bleeding of the gallbladder in a patient following blunt abdominal trauma. Contrast-enhanced computed tomography revealed pericholecystic fluid and extravasation of contrast material in the subcapsular ...

OBJECTIVE: The purpose of this study was to compare the effects of ticlopidine and clopidogrel on the development of neointimal hyperplasia after experimental arterial injury. METHODS: This experimental, prospective, randomized controlled study was performed on twenty-seven rabbits, which were divided into three groups, each of which contained nine subjects. Following ...

A 36-year old male was found dead inside a pub bath lying in a pool of blood. A small single-edged knife was discovered on the top of the water cistern. Multiple sharp weapon wounds at the usual sites of self-inflicted injuries were reported. It was possible to hypothesize a carotid ...

A retrospective analysis of operatively managed brachial artery injuries spanning a five-year period from January 2003 to December 2007. The medical records of all patients who had operative management of brachial artery injuries were reviewed. Demographic data, mechanism of injury, pathology of injury, associated injuries, duration of injury, operative management ...

Development of pseudo-aneurysm of the popliteal artery usually results from trauma, infection, or iatrogenic causes after orthopedic operations. This is to our knowledge the first reported case in the world's literature of a delayed presentation of a large above-knee popliteal artery pseudo-aneurysm following a soccer football injury. The pseudo-aneurysm severely ...

OBJECTIVE: Operation Iraqi Freedom has resulted in a significant number of closed and penetrating head injuries, and a consequence of both has been the accompanying neurovascular injuries. Here we review the largest reported population of patients with traumatic neurovascular disease and offer our experience with both endovascular and surgical management. ...

Heparin cofactor II (HCII) is a plasma protease inhibitor of the serpin family that inactivates thrombin by forming a covalent 1:1 complex. The rate of complex formation increases more than 1000-fold in the presence of dermatan sulfate (DS). Endothelial injury allows circulating HCII to enter the vessel wall, where it ...

An abdominal aortic aneurysm (AAA) is an enlargement of the greatest artery in the body defined as an increase in diameter of 1.5-fold. AAAs are common in the elderly population and thousands die each year from their complications. The most commonly used mouse model to study the pathogenesis of AAA ...

We report a case of internal carotid arterial damage following blunt neck trauma. This rare mechanism of injury demands a high index of suspicion to enable prompt specialist management. A 22-year-old man presented to hospital after sustaining blunt neck trauma. Rapid onset of stridor necessitated an emergency tracheostomy. Computed tomography ...

The optimal management strategy of an unstable penetrating thoracic trauma remains a debate. It is unclear whether a 'stay and treat' or 'scoop and run' to the nearest operating theatre with cardiothoracic expertise is the best strategy. We describe a successful outcome of a young patient with injuries to the ...

OBJECTIVE: In contrast to upper extremity stab and gunshot wounds, data on management and outcome in blunt trauma (BT) are limited by small numbers and short follow-up periods. METHODS: This study is a retrospective data analysis. All patients who had undergone arterial repair after upper-limb BT were included. Exclusion criteria ...

Iatrogenic intra-abdominal vascular injury can result from lumbar discectomy via the posterior approach. Although it is well known and documented in the literature, few anesthesiologists have personal experience with this life-threatening incident. Here, we report a patient who sustained perforation of the left internal iliac artery at the L(4-5) level ...

Axillary arterial injury is a rare complication of non-recurrent glenohumeral joint dislocation. Previously this type of injury would have required open exploration of the axillary artery with associated risk of iatrogenic injury to the axillary vein or brachial plexus. We present the case of a 75-year-old lady, who following a ...

BACKGROUND: The brachial artery is the most common vascular injury encountered in upper extremity trauma. If not treated promptly, it can result in compartment syndrome (CS) and long-term disability. Here, we report an institutional experience of traumatic brachial artery injuries and establish risk factors for the development of upper extremity ...

Blunt (non-penetrating) aortic injuries, in which the arterial wall is damaged in the direction from the intima towards the adventitia, are most commonly the result of a traffic accident. The various forms of blunt aortic injuries, from limited laceration of the intima to complete transection of the aorta, depend on ...

Vascular intervention-induced neointimal formation is a major drawback for managing atherosclerotic cardiovascular diseases using invasive vascular procedures. Our previous studies demonstrated that hirulog-like peptide (HLP) reduced balloon catheter dilation-induced neointimal formation or restenosis in carotid arteries of rats or atherosclerotic rabbits with less interruption in coagulation or bleeding than heparin ...

To discuss existing disparity of practice and clinical implications of measuring cerebral perfusion pressure (CPP) from differing reference points thus highlighting the need for standardized benchmarks. When managing traumatic brain injury (TBI), the arterial transducer level is a key to an accurate CPP reading; however, there is a lack of ...

Trauma is the leading cause of death under the age of 35 years worldwide. Traumatic aortic rupture is responsible for 18% of all road accident mortality. Eighty percent of these patients die at the scene of the accident. Of the survivors, 50% die within 24 hours if left untreated. Rapid ...

A balance between apoptosis and proliferation of vascular smooth muscle cells (VSMC) influences the development of intimal hyperplasia. We have previously demonstrated that protein kinase C delta (PKCdelta) regulates both apoptosis and proliferation of VSMC in vitro. Here we investigate the role of PKCdelta in intimal hyperplasia through gene deletion ...

The vertebral artery (VA) is well protected through its course at the cervical transverse foramina and penetrating injuries of VA are mostly caused by gun shot wounds. The mechanism of injury in these wounds is described as the kinetic energy transferred by the bullet, which always depends on its mass ...

BACKGROUND: Currently, only anecdotal information exists on the presentation and outcome of coronary arterial injury after ablation procedures. METHODS AND RESULTS: Four patients who sustained coronary artery injury of a cohort of patients undergoing 4655 consecutive ablation procedures (0.09%) are described. The patients' mean age was 45+/-11 years, and 1.8+/-0.5 ...

Background: Acute vascular injury is uncommon after cervical spine injury. We describe a recent case of active retropharyngeal bleeding from the thyrocervical artery after an acute cervical spine injury. Objectives: The case illustrates an unusual vascular injury diagnosed by 64-slice multidetector computed tomography (MDCT) and managed successfully by emergency transcatheter ...

BACKGROUND: IGF-1 is a potent mitogen for vascular smooth muscle cells, but exerts protective effects on endothelial cells that may trigger antiatherogenic mechanisms. OBJECTIVES: This study was designed to test the hypothesis that an IGF-1 excess following arterial injury prevents neointima formation and vascular stenosis. METHODS: Rats were subjected to ...

BACKGROUND: Angiography is the "gold standard" diagnostic tool for patients presenting soft signs of arterial injury. To reduce the number of unnecessary angiographies, we aimed to evaluate the role of the ankle brachial pressure index (ABPI) in the diagnosis of peripheral arterial injury in extremity trauma with soft signs. METHODS: ...

Vascular injury during lumbar disc surgery is a rare but potentially life-threatening complication. It has been managed by open vascular surgical repair. With recent technologic advance, endovascular treatment became one of effective treatment modalities. We present a case of a 32-year-old woman who suffered with common iliac artery injury during ...

Blunt carotid artery injury caused by shoulder belts is rare and requires a high index of suspicion to diagnose before the onset of neurologic sequelae. Neurologic abnormalities may be erroneously attributed to concomitant head trauma, and the onset of neurologic abnormalities may be delayed for hours or days. The case ...

The brachial artery is rarely injured after closed dislocation of the elbow. We describe an unusual variation of this injury, namely, a delayed thrombosis of the brachial artery after a closed dislocation sustained during a low-energy fall. This has not previously been described in the English literature, but may be ...

Tube thoracostomy insertion is a common procedure in the management of air and fluid collections in the pleural space. Pulmonary artery injury is a rare but serious complication following intercostal catheterisation. This complication is usually managed surgically. We report a case of successful non-operative management of a pulmonary artery injury ...

Traumatic inferior vena cava (IVC) injuries are highly lethal and require prompt surgical intervention. Traditional methods of vascular control include manual compression, gentle clamping or balloon occlusion catheters. These open methods require direct dissection into the hematoma for visualization, which can lead to massive hemorrhage. We present a case of ...

A 41-year-old male presented with penetrating carotid artery injury after being stabbed in the left neck with a knife. He had profuse bleeding from the wound and was in hemorrhagic shock. No neuroimaging evaluation was possible, so emergent surgery was begun with continuous manual compression of the left neck. Graft ...

Transcatheter arterial chemoembolization is one of the most common treatment modalities for hepatocellular carcinoma. Transcatheter arterial chemoembolization is considered to be a relatively safe procedure, but transcatheter arterial chemoembolization is associated with a number of disastrous complications. Among the ischaemic complications caused by transcatheter arterial chemoembolization, spinal cord injury is ...

OBJECTIVE: The aim of the study was to identify factors influencing surgical treatment outcome following upper extremity arterial injuries. METHODS: This 15-year study (January 1992 to December 2006) included 167 patients with 189 civilian, iatrogenic or military upper extremity arterial injuries requiring surgical intervention. Patient data were prospectively entered into ...

Surgical treatment often causes difficulty in the irradiated field because of delayed wound healing, which is mainly due to vascular dysfunction. To overcome this difficulty, we attempted to accelerate the recovery from clamp injury in irradiated superficial epigastric arteries of rats as a model. Etanercept, a soluble receptor of tumor ...

Aortic injury occurred during resternotomy in a 22-year-old woman who had undergone a Rastelli-type operation. Although extracorporeal circulation using the right femoral artery and vein was commenced immediately, hemostasis through the midline incision was impossible, and her circulation was hardly maintained. Thus, the parasternal approach was attempted, dividing the right ...

Traumatic vertebral artery (VA) injury has been neglected and mistaken to be innocuous. Herein, we present a rare case with a as subarachnoid hemorrhage (SAH) following blunt suboccipital trauma. Initially, it was mistaken as a saccular aneurysm and was just coincident with traumatic SAH. Surgical clipping was performed by our ...

A 74-year-old female with lung cancer underwent a right lower lobectomy by video-assisted thoracic surgery (VATS), and suddenly developed hemothorax soon after discharge. The bleeding point was an intercostal artery which faced a stump of the right lower vein divided by a stapler. Operative finding suggested that it was caused ...

Background: Popliteal artery injury can occur in up to one-third of patients with knee dislocation. Delay in the diagnosis of popliteal artery injury is the leading cause of amputation in this limb-threatening injury. Objectives: To remind emergency physicians to consider popliteal artery injury in any pulseless lower extremity, even in ...

Experiments were designed to test the hypothesis that the systemic delivery of planktonic forms of nanoparticles (NPs) derived from calcified, diseased human tissue or bovine blood are transmissible particles that exacerbate arterial response to injury. New Zealand White rabbits in which the endothelium was mechanically removed from one carotid artery ...