K M Yousuf1, A R Bhagwani2, N Bilal1. 1. Liaquat National Hospital and Medical College, Karachi, Pakistan. 2. Liaquat National Hospital and Medical College, Karachi, Pakistan. aarian_raw@yahoo.com.
Abstract
INTRODUCTION: Vascular injuries secondary to blunt or penetrating trauma are a significant cause of morbidity and mortality, especially in war-afflicted areas. Due to the violent situations of Pakistan and the unavailability of vascular services in remote areas, we are witnessing an increase in the number of delayed/chronic post-traumatic arteriovenous fistulas (AVFs) of the extremities in our institution. The purpose of this study is to share our experience of post-traumatic AVF and the incidence, presentation, and outcomes of these patients. METHODS: A 10-year retrospective study between January 2002 and May 2012 was conducted. We studied 30 patients with post-traumatic AVF of the lower limbs. RESULTS: All 30 cases were due to penetrating injuries, either by gun shots or bomb blasts. All of the patients were treated surgically, except for one patient who was treated with a covered stent. The interval between surgery and presentation ranged from 6 months to 20 years. All patients had complete obliteration of the fistulous tract and there was no recurrence and no post-operative mortality. CONCLUSION: Long-standing traumatic AVF is becoming common in Pakistan. Surgery remains the standard treatment.
INTRODUCTION:Vascular injuries secondary to blunt or penetrating trauma are a significant cause of morbidity and mortality, especially in war-afflicted areas. Due to the violent situations of Pakistan and the unavailability of vascular services in remote areas, we are witnessing an increase in the number of delayed/chronic post-traumatic arteriovenous fistulas (AVFs) of the extremities in our institution. The purpose of this study is to share our experience of post-traumatic AVF and the incidence, presentation, and outcomes of these patients. METHODS: A 10-year retrospective study between January 2002 and May 2012 was conducted. We studied 30 patients with post-traumatic AVF of the lower limbs. RESULTS: All 30 cases were due to penetrating injuries, either by gun shots or bomb blasts. All of the patients were treated surgically, except for one patient who was treated with a covered stent. The interval between surgery and presentation ranged from 6 months to 20 years. All patients had complete obliteration of the fistulous tract and there was no recurrence and no post-operative mortality. CONCLUSION: Long-standing traumatic AVF is becoming common in Pakistan. Surgery remains the standard treatment.
Authors: Juan A Asensio; Parinaz J Dabestani; Stephanie S Miljkovic; Florian A Wenzl; John J Kessler; Louay D Kalamchi; Tharun R Kotaru; Devendra K Agrawal Journal: Eur J Trauma Emerg Surg Date: 2021-01-02 Impact factor: 3.693