Vascular Trauma

What is vascular trauma?

Vascular trauma is an injury to your artery or vein due to trauma or blow. These injuries can affect the arterial, lymphatic, or venous system, and are most often located on a limb, especially lower ones (80-90% of cases). They are normally related to injuries to a limb or to joints affected by osteoarthritis. The most frequent clinical signs are either hemorrhage or acute ischemia. Early detection and treatment are crucial to prevent limb amputation, as well as to improve the prognosis for the patient.

Vascular injuries may be classed as penetrating or non-penetrating:

  • Penetrating trauma. The injury is caused by a foreign object piercing or crushing the skin (e.g. in armed conflicts this tends to be sharp and pointy objects). These may cause a blood vessel to rupture, cause bleeding and a hemorrhage, or cause thrombosis (blood clot).
  • Non-penetrating trauma. The injury may be caused by tissue compression or sudden deceleration. The vessel wall structure breaks, which can result in tearing and thrombosis.

Why is it Dangerous?

Blood vessel injury causes an abrupt cut-off in blood circulation to the legs/hands, leading to the death of the cells in that limb.

Any part of our body cannot survive beyond 4-6 hours without blood supply. A minor delay in vascular repair can cost the patient his/her limb or life.

What are the symptoms and signs of Vascular Injury?

  • High velocity injury to limb with or without fracture due to road traffic accident, industrial accidents, etc.
  • Sharp cut injury over the leg/hand
  • Feeling of numbness in the leg/hand
  • Loss of movement and sensation in the leg/hand (similar to paralysis)
  • Blue/black color changes in the toes/fingers

What is the treatment?

Treating vascular injuries will vary depending on the type and intensity of the injury. Endovascular treatment by embolization or injections is usually used, although they do not always cure the issue. Other techniques include endoprosthesis, which allows the vessel’s lumen to be kept open and avoid hemorrhage. These are quite commonly used for thoracic aortic ruptures or supra-aortic vessel injuries, as well as in high-risk patients with concomitant limb injuries. For patients who need an open surgical approach, there are many vascular reconstruction techniques: direct vascular suture, thrombectomy, and vascular plasty, bypass with vein or prosthesis, and vessel ligation.