The role of vascular specialist is crucial in vascular emergencies where there is injury to arteries or veins with excess bleeding.
We perform the following treatment methods for vascular emergencies:
- Surgical Repair of Bleeding Artery during surgery or fracture fixation
- Endovascular Embolisation of Pseudoaneurysms and control of bleeding
- Endovascular Stent-graft (covered stent) Placement for large vessel injury
Vascular trauma refers to injuries to the blood vessels, including arteries and veins. This can occur as a result of blunt or penetrating trauma, such as a fall, road accident or a penetrating wound like knife or gunshot wound.
Vascular trauma can be caused by a variety of factors, including:
Blunt trauma: This occurs when a blood vessel is crushed or compressed by a blunt force, such as a car accident, road traffic accident or a fall.
Penetrating trauma: This occurs when a blood vessel is punctured or lacerated by a sharp object, such as a knife or a bullet.
Iatrogenic causes: This refers to trauma caused by medical procedures, such as a catheterization or an angiogram.
Infections: Certain infections, such as endocarditis (an infection of the inner lining of the heart) or sepsis (a systemic infection), can damage blood vessels and lead to vascular trauma.
Diseases: Certain medical conditions, such as atherosclerosis (hardening of the arteries), or vasculitis can weaken the walls of blood vessels and increase the risk of injury.
Medical conditions: Certain medical conditions, such as blood disorders, can increase the risk of bleeding and injury to the blood vessels.
Vascular malformations: These are abnormal growths or deformities in the blood vessels that can increase the risk of injury or rupture.
It is important to note that some of these factors may be influenced by lifestyle choices, such as smoking, poor diet, and lack of physical activity, and can therefore be partly managed through lifestyle modifications.
The treatment for vascular trauma depends on the type and severity of the injury, as well as the overall health of the patient.
Some common treatment options include:
Surgical repair: In some cases, the injured vessel can be repaired using surgical techniques, such as suturing or bypass surgery. This is typically done under anesthesia and may involve making an incision in the affected area to access the injured vessel.
Bypass surgery: In some cases, the affected vessel may need to be bypassed using a vein or artificial graft. This is typically done when the injury is too severe to be repaired with a simple surgical procedure. Along with this, repair of bone, muscles or nerves may be required.
Endovascular procedures: These are minimally invasive procedures that use catheters and other devices to treat injuries to blood vessels from inside the vessel, without the need for an open surgical incision. The use of covered scents or endografts has revolutionized the management of large vessel trauma as the bleeding can be controlled while maintaining the potency of the vessel. Coil embolisation is another technique suitable for smaller vessel trauma, in which small microcatheters are passed into the bleeding vessel and special coils or glue is injected to control the bleeding.
Medications: In some cases, medications may be used to manage symptoms and improve blood flow. This may include anticoagulants (such as heparin) to prevent blood clots, or vasodilators (such as nitrates) to improve blood flow and reduce pain.
Observation: In some cases, particularly for minor injuries, the patient may be observed and monitored for changes in symptoms without the need for immediate treatment.
It is important to note that early and prompt treatment is crucial in preventing serious complications and promoting the best outcome. In cases of severe or life-threatening vascular trauma, emergency medical attention is necessary.
Hard signs of vascular injury are physical findings that indicate an injury to a blood vessel. They are considered more reliable indicators of vascular injury than soft signs and may require prompt intervention.
Hard signs of vascular injury include:
Active arterial bleeding: This is the most obvious hard sign of vascular injury and can be seen as pulsatile bleeding, which may be accompanied by a thrill (a palpable vibration).
Absence of pulse: The absence of a pulse in an extremity can indicate a significant injury to an artery.
Bruits: A bruit is a swishing or whooshing sound that can be heard over an injured vessel with a stethoscope. This is caused by turbulence in the flow of blood and can indicate a significant injury or an an arteriovenous fistula.
Hematoma: A hematoma is a swelling filled with blood that can occur as a result of injury to a blood vessel. It may be accompanied by a palpable thrill or a change in skin color.
Distal ischemia: Distal ischemia refers to a lack of blood flow to a specific area of the body, such as an extremity. This can occur as a result of injury to an artery and can lead to pain, numbness, tingling or reduced movements in the affected area.
These hard signs may indicate a significant injury to a blood vessel and require prompt medical attention. Early recognition and treatment can help prevent serious complications and promote the best outcome, so one should consult Vascular Specialist doctor for physical examination and treatment.
Vascular trauma can be life-threatening in certain cases. The severity of the injury and the location of the affected blood vessel are important factors that can determine the prognosis. For example, injuries to the major blood vessels, such as the aorta or the carotid arteries, can be particularly dangerous and may cause significant blood loss or even death.
Injuries to smaller blood vessels, such as veins or small arteries, may not be immediately life-threatening but can still have significant consequences if left untreated. For example, an injury to a blood vessel in the limb can cause distal ischemia (lack of blood flow) and lead to pain, numbness, or tingling. If not treated promptly, this can progress to limb loss or permanent nerve damage.
It is important to seek prompt medical attention in cases of suspected vascular trauma, as early recognition and treatment can help prevent serious complications and promote the best outcome. In cases of severe or life-threatening vascular trauma, emergency medical attention is necessary.
Vascular damage can cause symptoms such as pain, tingling or numbness, weakness, changes in skin color, swelling, and bruising. These symptoms may indicate a significant injury to a blood vessel and require prompt medical attention.
The exact incidence of vascular trauma is difficult to determine, as it can range from minor injuries to life-threatening injuries. However, it is estimated that vascular injuries make up approximately 5-10% of all traumatic injuries.
Vascular trauma can occur as a result of a wide range of causes, including blunt or penetrating trauma, iatrogenic injury (injury caused by medical procedures), and medical conditions such as aneurysms or thrombosis.
In general, the incidence of vascular trauma is higher in individuals who are at increased risk for traumatic injuries, such as those who participate in high-risk sports or industrial activities, or those who work in high-risk industries.
Yes, many vascular problems can be fixed. The specific treatment will depend on the type and severity of the vascular problem, as well as the underlying cause.
In some cases, your doctor may do non-invasive measures, such as lifestyle changes (such as quitting smoking, eating a healthy diet, and exercising regularly), may be sufficient to improve or resolve the vascular problem. In more severe cases, however, invasive procedures, such as angioplasty, stenting, or surgery, may be necessary.
For example, in cases of arteriosclerosis (narrowing of the arteries), angioplasty or stenting can be used to open up the affected blood vessel and restore blood flow. In cases of an aneurysm (a weak or bulging area in the wall of a blood vessel), surgery may be necessary to repair or remove the affected area.
Yes, in many cases, vascular damage can be repaired with various treatments such as sutures, surgery, angioplasty, stenting, or lifestyle changes. The specific treatment will depend on the type and severity of the vascular damage, as well as the underlying cause. Early recognition and treatment can help prevent serious complications and promote the best outcome.
Soft signs of vascular injury refer to symptoms that suggest an injury to a blood vessel, but do not provide definitive evidence of an injury. These signs are typically less specific and less severe than hard signs of vascular injury, but can still indicate a need for prompt medical attention.
Some common soft signs of vascular injury include:
Pain or discomfort in the affected area: This can range from a mild ache to a severe and persistent pain.
Tingling or numbness: This may indicate a reduced blood flow to the affected area.
Weakness or fatigue: This may occur if the blood flow to the affected area is reduced or disrupted.
Changes in skin color: The affected area may become pale, blue, or red, depending on the extent and severity of the injury.
Swelling or tenderness: This may occur if there is fluid buildup or inflammation in the affected area.
Bruising: This may occur if there has been a traumatic injury to the affected area.
It is important to seek prompt medical attention in cases of suspected vascular injury, as early recognition and treatment can help prevent serious complications and promote the best outcome. In cases of severe or life-threatening vascular trauma, emergency medical attention is necessary. Further evaluation by doppler or Angiography may be useful for the same.
Angioembolisation for bleeding after fracture fixation
Angiography shows Femoral AV Fistula
Femoral AV Fistula Repair
Brachial repair in supracondylar humerus fracture
Popliteal artery injury repair
1. Popliteal injury
2. Gunshot induced Iliac Arterio-Venous Fistula