Document Detail


Iatrogenic vascular injuries in varicose vein surgery: a systematic review.
MedLine Citation:
PMID:  17180475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Iatrogenic vascular injuries during varicose vein surgery are serious. The aim of this study was to investigate their nature and consequences. METHOD: A systematic literature research was performed. RESULTS: The incidence is low (0.0017%-0.3%). We found 81 patients suffering from 87 vascular injuries-44 arterial and 43 deep vein injuries. CONCLUSION: Vascular injuries during varicose surgery are rare but serious. They are avoidable, and when they occur, early recognition is crucial. Bleeding is a common symptom, especially in deep venous injury. In our study, we reviewed the literature on 81 patients with 87 vascular injuries. Laceration or division of the femoral vein dominated venous injuries (28/43). Partial stripping of the femoral vein was not common (4/43) and occurred when the strip probe passed into the deep veins through a perforator. Arterial stripping predominated in arterial injuries (17/44) and happened when stripping distally during a primary operation, as reported by experienced surgeons, in nonobese women. Major arterial complications resulted in ischemia, often with diagnostic delay and poor reconstruction results. Only 30% (13/44) of arterial injuries were detected peroperatively. The amputation rate was 34% (15/44), but rose to 100% if combined with intra-arterial sclerotherapy (5/5 cases). When stripping an artery below the femoral artery, the amputation rate was high (42%; 5/12) and morbidity severe (85%; 11/12). All fatal injuries (5 cases) were venous. Anatomic knowledge and awareness of the possibility of vascular complications should be preventive. Early detection by routine checking of arterial circulation is important.
Authors:
Håkan Rudström; Martin Björck; David Bergqvist
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-11     Completed Date:  2007-02-27     Revised Date:  2007-10-12    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  228-33     Citation Subset:  IM    
Affiliation:
Department of Surgery, Uppsala University Hospital, Uppsala, Sweden. hakan.rudstrom@akademiska.se
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MeSH Terms
Descriptor/Qualifier:
Femoral Artery / injuries*
Femoral Vein / injuries*
Humans
Iatrogenic Disease / epidemiology*
Lacerations / epidemiology*
Varicose Veins / surgery*
Vascular Surgical Procedures / adverse effects*
Comments/Corrections
Comment In:
World J Surg. 2007 Jul;31(7):1528; author reply 1529   [PMID:  17483985 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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