Perspectives in vascular surgery and endovascular therapy
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Data from the Joint Theater Trauma Registry has led to changes in combat casualty care for Operations Iraqi and Enduring Freedom compared with previous wars. Currently, all recognized vascular injuries are repaired before leaving Iraq or Afghanistan. Extremity injuries are prevalent, accounting for the majority of reconstructive vascular surgery performed. ⋯ Use of autogenous or prosthetic grafts, vascular shunting, diagnostic imaging, and negative pressure wound therapy should continue to be encouraged. All of these advances contributed to an increase in amputation-free survival rates. The management of combat-related vascular injuries has progressed to the point of achieving reasonable outcomes for our country's military casualties.
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Perspect Vasc Surg Endovasc Ther · Mar 2011
Torso vascular trauma at an urban level-I trauma center.
Injuries to the great vessels of the torso are commonly seen and managed in busy urban trauma centers. This same injury complex is rarely seen in military conflicts, likely because of the high kinetic energy of weapons causing the wounds seen in this setting. Although most of the great advancements in trauma surgery over the past century have generally resulted from our wartime experience, civilian centers have contributed greatly to the understanding and management of torso vascular injuries. This article reviews the presentation and management of injuries to the great vessels of the torso from major penetrating and blunt trauma.
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Perspect Vasc Surg Endovasc Ther · Mar 2011
Review Historical ArticleVascular trauma historical notes.
This article provides a brief historical review of treatment of vascular trauma. Although methods for ligation came into use in the second century, this knowledge was lost during the Dark Ages and did not come back until the Renaissance. ⋯ Increased documentation has revealed that the current conflicts have resulted in more arterial injuries than in previous wars, likely because of improved body armor, improvised explosive device attacks, tourniquet use, and improved medical evacuation time. This brief review emphasizes the great value of mentorship and the legacy of the management of arterial and venous injuries to be passed on.
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Blunt aortic injury is second only to head injury as the most common cause of blunt trauma related death. The past several years have seen a tremendous growth in the endovascular treatment of such trauma. Short-term and medium-term follow-up data that are emerging seem to support this trend. In this article, the authors discuss about open and endovascular management of blunt aortic injury and provide the latest information regarding endovascular repair of such injuries.