The treatment of vascular trauma is a challenging and increasingly successful endeavor. Improvement in patency rates and limb salvage have occurred through advances in diagnostic methods, materials for vessel replacement and techniques of repair. Several principals have evolved. An aggressive diagnostic approach is indicated with early arteriography in all suspicious injuries. Distal blood flow should be established as soon as possible. Associated venous injuries should be repaired if possible. Unstable orthopedic injuries shoud be stabilized conservatively with minimal internal wire fixation of fragments and the use of traction. Fasciotomy should be used in treatment of any injury involving prolonged ischemia of distal tissues.
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J Trauma Acute Care Surg
January 2025
From the Department of Trauma Services (E.W.R., B.S., M.L., M.R.), OhioHealth Grant Medical Center, Columbus; and Ohio University Heritage College of Osteopathic Medicine (K.W., N.K.), Athens, Ohio.
Background: Computed tomography angiography of the head (CTAH) is not routinely obtained during the initial evaluation of patients with traumatic intracranial hemorrhage (ICH); however, it is useful for diagnosing vascular pathologies that may have led to the bleed. The aims of this study were to identify traumatic ICH patient characteristics on presentation that are associated with positive CTAH findings to elucidate which ones should prompt a CTAH and compare outcomes of patients with positive and negative CTAH findings.
Methods: This is a retrospective cohort study of 522 patients who had blunt traumatic ICH and subsequently received CTAH between January 1, 2017, and January 1, 2022.
Proc Natl Acad Sci U S A
February 2025
Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158.
The ε4 variant of human apolipoprotein E () is a key genetic risk factor for neurodegeneration in Alzheimer's disease and elevated all-cause mortality in humans. Understanding the factors and mechanisms that can mitigate the harmful effects of has significant implications. In this study, we find that inactivating the VHL-1 (Von Hippel-Lindau) protein can suppress mortality, neural and behavioral pathologies caused by transgenic human in .
View Article and Find Full Text PDFTrauma Case Rep
February 2025
Department of Surgery, Trauma & Vascular Surgery, Clinical Research, Hamad Medical Corporation, Doha, Qatar.
Car Gearbox explosion-related injuries are very rare but could be serious. We reported a 43-year-old female patient who sustained severe bilateral lower limb injuries following an explosion of the gearbox in her private car while waiting at a traffic signal. The patient suffered from a left open tibia shaft fracture and severely macerated soft tissues, along with an open wound on the right leg.
View Article and Find Full Text PDFFront Surg
January 2025
Department of Urology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Background: There is no systematic classification of renal vascular injuries conducted for severe post-percutaneous nephrolithotomy (PCNL) bleeding.
Aim: The aim of the present study was to explore the various types of artery injury and clinical characteristics of patients who underwent transcatheter angioembolization (TAE) after PCNL.
Methods: A retrospective analysis was performed on 52 patients who underwent renal arteriography (RA) because of severe bleeding after PCNL between April 2009 and December 2023.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Faculty of Medicine, Azad Tehran University of Medical Sciences, Tehran, Iran.
Background: Pedicle screw insertion in posterior spinal surgery can cause vascular injuries, including rare intercostal artery pseudoaneurysms, which are typically discovered incidentally during reimaging. Onyx embolization is an effective treatment for small artery pseudoaneurysms.
Observations: A 36-year-old man who had initially presented with back pain that remained unresponsive to nonsteroidal anti-inflammatory drugs was diagnosed with a T7-8 sarcomatous lesion confirmed by magnetic resonance imaging and biopsy.
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