Main Article Content
Abstract
ABSTRACT
Introduction. Les traumatismes vasculaires des membres sont des situations d’urgences diagnostiques et thérapeutiques, qui peuvent mettre en jeu le pronostic fonctionnel et, dans un certain nombre de cas non négligeable, le pronostic vital des patients. Matériel et méthodes. Nous avons mené, au sein du centre des urgences de Yaoundé, une étude rétrospective et descriptive, allant d’octobre 2017 à novembre 2019, soit une durée de 2 ans et 3 mois. Tous les patients opérés pour un traumatisme vasculaire des membres durant la période, dont les dossiers étaient complets, ont été inclus. Résultats. Durant la période, 26 patients ont été opérés pour un traumatisme vasculaire de membre. Les patients étaient majoritairement de sexe masculin et leur moyenne d’âge était de 34 ans. Les circonstances ayant conduit à ces traumatismes étaient dominées par les agressions par arme blanche (17 cas). Le saignement constituait la présentation clinique la plus fréquente. L’artère brachiale (13 cas) était le vaisseau le plus lésé. La technique de réparation vasculaire la plus utilisée était un pontage veineux avec un greffon de veine céphalique. En post opératoire, une seule amputation a dû être réalisée pour une thrombose précoce d’un pontage. Dans la série, cinq patients ont présenté des complications et nous avons enregistré le décès de trois patients. Conclusion. Les traumatismes vasculaires demeurent un problème d’actualité dans notre pratique quotidienne. Ils font suite à des agressions par armes blanches et siègent préférentiellement au membre supérieur, chez des personnes de sexe masculin et relativement jeunes. Les taux de sauvetage des membres, de morbidité et de mortalité demeurent bons au vu des données de la littérature, et surtout du contexte de la pratique quotidienne.
RÉSUMÉ
Introduction. Vascular injuries of the limbs are diagnostic and therapeutic emergencies, which can involve the functional prognosis or in some cases, can be life threatening situation. Material and methods. We conducted a retrospective and descriptive study at the Yaoundé Emergency Center, from October 2017 to November 2019. All patients operated on for vascular trauma of the limbs during the period, whose records were complete, were included. Results. During the period, 26 patients underwent surgery for vascular limb trauma. The patients were predominantly male and their average age was 34 years. The circumstances leading to these injuries were dominated by stabbing (17 cases). Bleeding was the most frequent clinical presentation. The brachial artery (13 cases) was the most injured vessel. The most commonly used vascular repair technique was venous bypass with a cephalic vein graft. Postoperatively, only one amputation had to be performed for early thrombosis of a bypass graft. In the series, five patients had complications and we recorded the death of three patients. Conclusion. Vascular trauma remains a current problem in our daily practice. They follow stabbing attacks and occur preferentially in the upper limb, in relatively young male patients. The rates of limb salvage, morbidity and mortality remain good in view of the data in the literature, and especially in the context of daily practice.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Edward J. Newton and Sanjay Arora. Chapter 48 Peripheral Vascular Injury.In Part II Trauma Section Two • System Injuries.Pp500-510e3
- De Silva WDD, Ubayasiri RA, Weerasinghe CW, Wijeyaratne SM. Challenges in the management of extremity vascular injuries: A wartime experience from a tertiary centre in Sri Lanka. World J Emerg Surg. 2011;6:24
- Shireman et al.: VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration. BMC Surgery 2015 15:13. doi:10.1186/1471-2482-15-13.
- Feliciano David V., Moore Frederick A., Moore Ernest E., West Michael A., Davis James W., Cocanour Christine S., Kozar Rosemary A., and McIntyre Jr Robert C. Evaluation and Management of Peripheral Vascular Injury. Part 1. Western Trauma Association/Critical Decisions in Trauma. J Trauma. 2011;70: 1551–1556. DOI: 10.1097/TA.0b013e31821b5bdd
- Dieng Papa Adama, Diop Momar Sokhna, Gaye Magaye, et al. Vascular Traumatism of Limbs in Civil Practice in Dakar. Cardiol Vasc Res. 2018; 2(4)
- Adeoye PO, Adebola SO, Adesiyun OAM, Braimoh KT. Peripheral vascular surgical procedures in Ilorin, Nigeria: indications and outcome. African Health Sciences 2011; 11(3): 433 – 437
- Yangni-Angate H., Ayegnon G., Meneas C.H., Yapobi Y. and Kangah M. Arterial trauma of the extremities. An Ivorian surgical experience (Côte d’Ivoire). Nigerian Journal of Surgical Research. Vol 8 No1 2,2007: 49 53
- Aduful H.K. and Hodasi W.M. Peripheral vascular injuries and their management in Accra. Ghana Medical Journal Volume 41, Number 4 PP 186-9
- Fokou M., Chichom MA., Eyenga VC., Nguifo M.l., Ngo Nonga B., Bahebeck J., Teyang A., Pagbe J.J. Les traumatismes vasculaires périphériques en pratique civile : À propos de 41 lésions opérées au Cameroun. Chirurgie Thoracique Cardio-Vasculaire - 2011; 15(3) : 145-149
- Randimbinirina Z L, Rajaobelison T, Randrianarisoa F F, Ravalisoa M L A, Rakotoarisoa A J C. Plaies vasculaires périphériques post-traumatiques vues au Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo. Rev. Anesth.-Réanim. Med. Urg. Toxicol. 2018 (Janvier-Juin) ;10(1) : 1-4.
- Baghi Iraj, Herfatkar Mohammad Rasool, Shokrgozar Leila, Poor-Rasuli Zahra, and Aghajani Fatemeh. Assessment of Vascular Injuries and Reconstruction. Trauma Mon. 2015 November; 20(4): e30469. doi: 10.5812/traumamon.30469.
- Güven C, Kafadar H. Evaluation of extremity vascular injuries and treatment approaches. Niger J Clin Pract 2020;23:1221-8. Doi: 10.4103/njcp.njcp_656_18
- Khan Fahad H, Yousuf Kamal M. and Bagwani Anel R. Vascular injuries of the extremities are a major challenge in a third world country. Journal of Trauma Management & Outcomes (2015) 9:5 DOI 10.1186/s13032-015-0027-0
- Siddique Muhammad Khalid, Bhatti Ahsin Manzoor. A two-year experience of treating vascular trauma in the extremities in a military hospital. J Pak Med Assoc Vol. 63, No.3, March 2013 pp 327-30
- Li Zhui, Zhao Liang, Wang Kaizhen, Cheng Jun, Zhao Yu, Ren Wei. Characteristics and treatment of vascular injuries: a review of 387 cases at a Chinese center. Int J Clin Exp Med 2014;7(12):4710-4719
- Thomas M O, Giwa S O and Adekoya-Cole T O. Arterial injuries in civilian practice in Lagos, Nigeria. Nigerian journal of clinical practice. Dec 2005: vol 8(2): 65-68
- Hemingway Jake, Adjei Enock, Desikan Sarasijhaa, Gross Joel, Tran Nam, Singh Niten, Starnes Benjamin, and Quiroga Elina. Lowering the AnkleeBrachial Index Threshold in Blunt Lower Extremity Trauma May Prevent Unnecessary Imaging. Ann Vasc Surg 2020; 62: 106–113. https://doi.org/10.1016/j.avsg.2019.05.052
- Doody O., Given M.F., Lyon S.M. Extremities Indications and techniques for treatment of extremity vascular injuries. Injury, Int. J. Care Injured (2008) 39, 1295—1303. doi : 10.1016/j.injury.2008.02.043
- D’Alessio Ilenia, Domanin Maurizio, Bissacco Daniele, Romagnoli Silvia, Rimoldi Pierantonio, Sammartano Fabrizio, and Chiara Osvaldo. Operative Treatment and Clinical Outcomes in Peripheral Vascular Trauma: The Combined Experience of Two Centers in the Endovascular Era. Ann Vasc Surg 2020; 62: 342–348. https://doi.org/10.1016/j.avsg.2019.06.037
- Kuwahara Jeffery T., Kord Ali, Ray, Jr Charles E. Penetrating Extremity Trauma Endovascular versus Open Repair? Semin Intervent Radiol 2020;37:55–61. DOI https://doi.org/10.1055/s-0039-3401840
- Weaver John J., Chick Jeffrey F.B., Monroe Eric J., Johnson Guy E. Life and Limb: Current Concepts in Endovascular Treatment of Extremity Trauma. Semin Intervent Radiol 2021;38:64–74. DOI https://doi.org/10.1055/s-0041-1724011.
References
Edward J. Newton and Sanjay Arora. Chapter 48 Peripheral Vascular Injury.In Part II Trauma Section Two • System Injuries.Pp500-510e3
De Silva WDD, Ubayasiri RA, Weerasinghe CW, Wijeyaratne SM. Challenges in the management of extremity vascular injuries: A wartime experience from a tertiary centre in Sri Lanka. World J Emerg Surg. 2011;6:24
Shireman et al.: VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration. BMC Surgery 2015 15:13. doi:10.1186/1471-2482-15-13.
Feliciano David V., Moore Frederick A., Moore Ernest E., West Michael A., Davis James W., Cocanour Christine S., Kozar Rosemary A., and McIntyre Jr Robert C. Evaluation and Management of Peripheral Vascular Injury. Part 1. Western Trauma Association/Critical Decisions in Trauma. J Trauma. 2011;70: 1551–1556. DOI: 10.1097/TA.0b013e31821b5bdd
Dieng Papa Adama, Diop Momar Sokhna, Gaye Magaye, et al. Vascular Traumatism of Limbs in Civil Practice in Dakar. Cardiol Vasc Res. 2018; 2(4)
Adeoye PO, Adebola SO, Adesiyun OAM, Braimoh KT. Peripheral vascular surgical procedures in Ilorin, Nigeria: indications and outcome. African Health Sciences 2011; 11(3): 433 – 437
Yangni-Angate H., Ayegnon G., Meneas C.H., Yapobi Y. and Kangah M. Arterial trauma of the extremities. An Ivorian surgical experience (Côte d’Ivoire). Nigerian Journal of Surgical Research. Vol 8 No1 2,2007: 49 53
Aduful H.K. and Hodasi W.M. Peripheral vascular injuries and their management in Accra. Ghana Medical Journal Volume 41, Number 4 PP 186-9
Fokou M., Chichom MA., Eyenga VC., Nguifo M.l., Ngo Nonga B., Bahebeck J., Teyang A., Pagbe J.J. Les traumatismes vasculaires périphériques en pratique civile : À propos de 41 lésions opérées au Cameroun. Chirurgie Thoracique Cardio-Vasculaire - 2011; 15(3) : 145-149
Randimbinirina Z L, Rajaobelison T, Randrianarisoa F F, Ravalisoa M L A, Rakotoarisoa A J C. Plaies vasculaires périphériques post-traumatiques vues au Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo. Rev. Anesth.-Réanim. Med. Urg. Toxicol. 2018 (Janvier-Juin) ;10(1) : 1-4.
Baghi Iraj, Herfatkar Mohammad Rasool, Shokrgozar Leila, Poor-Rasuli Zahra, and Aghajani Fatemeh. Assessment of Vascular Injuries and Reconstruction. Trauma Mon. 2015 November; 20(4): e30469. doi: 10.5812/traumamon.30469.
Güven C, Kafadar H. Evaluation of extremity vascular injuries and treatment approaches. Niger J Clin Pract 2020;23:1221-8. Doi: 10.4103/njcp.njcp_656_18
Khan Fahad H, Yousuf Kamal M. and Bagwani Anel R. Vascular injuries of the extremities are a major challenge in a third world country. Journal of Trauma Management & Outcomes (2015) 9:5 DOI 10.1186/s13032-015-0027-0
Siddique Muhammad Khalid, Bhatti Ahsin Manzoor. A two-year experience of treating vascular trauma in the extremities in a military hospital. J Pak Med Assoc Vol. 63, No.3, March 2013 pp 327-30
Li Zhui, Zhao Liang, Wang Kaizhen, Cheng Jun, Zhao Yu, Ren Wei. Characteristics and treatment of vascular injuries: a review of 387 cases at a Chinese center. Int J Clin Exp Med 2014;7(12):4710-4719
Thomas M O, Giwa S O and Adekoya-Cole T O. Arterial injuries in civilian practice in Lagos, Nigeria. Nigerian journal of clinical practice. Dec 2005: vol 8(2): 65-68
Hemingway Jake, Adjei Enock, Desikan Sarasijhaa, Gross Joel, Tran Nam, Singh Niten, Starnes Benjamin, and Quiroga Elina. Lowering the AnkleeBrachial Index Threshold in Blunt Lower Extremity Trauma May Prevent Unnecessary Imaging. Ann Vasc Surg 2020; 62: 106–113. https://doi.org/10.1016/j.avsg.2019.05.052
Doody O., Given M.F., Lyon S.M. Extremities Indications and techniques for treatment of extremity vascular injuries. Injury, Int. J. Care Injured (2008) 39, 1295—1303. doi : 10.1016/j.injury.2008.02.043
D’Alessio Ilenia, Domanin Maurizio, Bissacco Daniele, Romagnoli Silvia, Rimoldi Pierantonio, Sammartano Fabrizio, and Chiara Osvaldo. Operative Treatment and Clinical Outcomes in Peripheral Vascular Trauma: The Combined Experience of Two Centers in the Endovascular Era. Ann Vasc Surg 2020; 62: 342–348. https://doi.org/10.1016/j.avsg.2019.06.037
Kuwahara Jeffery T., Kord Ali, Ray, Jr Charles E. Penetrating Extremity Trauma Endovascular versus Open Repair? Semin Intervent Radiol 2020;37:55–61. DOI https://doi.org/10.1055/s-0039-3401840
Weaver John J., Chick Jeffrey F.B., Monroe Eric J., Johnson Guy E. Life and Limb: Current Concepts in Endovascular Treatment of Extremity Trauma. Semin Intervent Radiol 2021;38:64–74. DOI https://doi.org/10.1055/s-0041-1724011.