Evaluation of Outcomes and Treatment Options Among Trauma Patients with Abdominal Vascular Injuries

Abdominal Vascular Injuries

Abstract

Introduction.  Abdominal vascular injuries are rare and are associated with significant morbidity and mortality. Treatment options include nonoperative management, open repair, and endovascular procedures. This study aimed to characterize patients and detail treatment modalities among those who sustained a traumatic abdominal vascular injury.

Methods.  A 6-year descriptive retrospective study was conducted at an American College of Surgeons-verified level 1 trauma center and included all adult patients who sustained an abdominal vascular injury.

Results.  Most vascular injuries were to the iliac artery (27.9%), abdominal aorta (25.6%), and inferior vena cava (25.6%). Twenty-seven percent of patients sustained an injury to more than one vascular structure. Thirty-four percent of patients died before treatment of the abdominal vascular injury. Among the 28 patients (65.1%) treated for their vascular injuries, 46.4% were treated with open surgery, 32.1% were treated nonoperatively and 21.4% with coil embolization. The most common vascular injuries treated were lacerations (56%) and transections (21%). Sixty-four percent of the patients who survived to discharge presented for follow-up care with a mean follow-up period of 3 ± 4.1 months. There were no vascular reinterventions after discharge for patients who followed up with our hospital. 

Conclusions.  Study findings suggests that appropriately selected cases of traumatic vascular injuries may be safely managed nonoperatively, as there were no mortalities, complications, or reinterventions among these patients.