Iatrogenic Vascular Injuries in Resource-Limited Setting: A 4-Year Experience Monocentric Retrospective Study

Figures & data

Figure 1 Arterial aneurysms caused by repeated central line access (A) Right subclavian artery aneurysm. (B) left subclavian to axillary artery aneurysm. (C) left brachial artery pseudoaneurysm).

Table 1 Patient Characteristics and Causes of Iatrogenic Vascular Injuries

Variables	N (%)
Age (Year), Mean± SD	37.1±17.0 (Range 0.5–62.0)
Gender
Male	23 (65.7%)
Female	12 (34.3%)
Symptoms of injuries
Pseudoaneurysm	15 (42.9%)
Acute limb ischemia	7 (20.0%)
Hematoma	4 (11.4%)
Hemorrhagic shock	2 (5.7%)
Aneurysm	1 (2.9%)
Specialty
Non-specialized healthcare workers	15 (42.9%)
Cardiologist	6 (17.1%)
Gynecologist	4 (11.4%)
Orthopedist	4 (11.4%)
Urologist	3 (8.6%)
General Surgeon	3 (8.6%)

Table 2 The Anatomical Distribution of Vascular Injuries

Name of Involved Vessel	N (%)	Causes
Femoral artery	7 (20.0%)	6 during PCI and one in vascular access for hemodialysis*
Brachial artery	6 (17.1%)	Vascular access for hemodialysis*
Iliac artery	4 (11.43%)	During pelvic tumor resections and gynecologic operations
Radial / Ulnar artery	4 (11.4%)	During dialysis cannulation*
Subclavian artery	3 (8.6%)	Vascular access for hemodialysis*
Inferior vena cava	3 (8.6%)	Two during biliary tract surgery and one during tumor resection
Popliteal artery	2 (5.7%)	Orthopedic procedures
Abdominal aorta	2 (5.7%)	One after PDA closure and one during tumor resection
Carotid artery	1 (2.9%)	During thyroidectomy
Jugular vein	1 (2.9%)	Vascular access for hemodialysis*
Posterior tibial artery	1 (2.9%)	Orthopedic procedures
Anterior tibial artery	1 (2.9%)	Orthopedic procedures

Notes: *Occurred by non-qualified specialists for end-stage kidney disease patients.

Abbreviations: PDA: Patent ductus arteriosus closure, PCI: Percutaneous coronary intervention.

Table 3 Operative and Postoperative Characteristics of IVIs

Variables	N (%)
Operative management*
Primary repair	25 (71.4%)
Bypass	5 (14.3%)
Ligation	3 (8.6%)
Operative time (min), Mean± SD	104.4± 14.4 (Range 67.0–130.0)
Follow-up time months, mean ±SD	1.5 ±0.6
Death	3 (8.6%)
Complication and outcome	7 (20.0%)
Superficial wound Infection	4 (11.6%)
Graft thrombosis	1 (2.9%)
Reoperation	1 (2.9%)
Amputation	1 (2.9%)

Note: *Some patients required multiple procedures.

Figure 2 Computed tomography scan showing (A) partial laceration of superficial femoral artery (blue arrow), (B) Intraoperative image showing complete cutting of superficial femoral artery (yellow arrow); (C) Intraoperative image showing complete cutting of popliteal artery (yellow arrow).