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Volume : 34 Issue : 2 Year : 2019



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Iatrogenic vascular injuries [Medeniyet Med J]
Medeniyet Med J. 2005; 20(1): 38-41

Iatrogenic vascular injuries

Muzaffer Bahcivan, Mustafa Kemal Demirağ, Hasan Tahsin Keçeligil, Atilla Saraç, Hakan Karamustafa, Semih Murat Yücel, Ferşat Kolbakır
Nineteen May University School of Medicine, Department of Cardiovascular Surgery, Samsun

We are providing here a retrospective evaluation of vascular injuries occuring due to iatrogenic reasons and the surgical operations performed in the treatment.
Surgical operations were performed on 52 cases with iatrogenic vascular injuries between 1984-2004 at our cardiovascular surgery clinic. The patients included 33 males and 19 females, with a mean age of 52. Vascular injury occured at 45 patients during cardiac catheterization and angiography attempts, at 4 patients during peripheric angiography and at 3 patients during femoral arterial canulation attemps. Vascular injury led to thrombosis at 29 cases, ruptur and hematoma at 18 cases, pseudoaneurysm at 2 cases and LAD (Left anterior descending) artery at 2 cases and circumflex (Cx) artery at 1 case. Embolectomy was performed on 28 cases, drenage of hematoma and primary repair of the vessel was performed on 14 cases, excision of pseudoaneurysm on 2 cases, LAD artery and Cx artery repair in 3 cases, femoro-femoral bypass from
left to right at 3 cases, and iliofemoral bypass operation was performed at 2 cases.
Cardiac catheterization and angiography attempt was the precedure leading to the highest rate of injuries (86.53 %). Right femoral arterial was most prone to injuries. Amputation were performed on 3 patients, 2 of these were at the top of the knee and 1 was total hip desarticulation (5.7 %). The rest of the patients fully recovered.
Iatrogenic vascular injuries are important surgical matters requiring early detection and treatment. This is the only way of achieving reduced mortality and morbidity.

Keywords: Iatrogenic vascular injuries, catheterization, embolectomy, amputation


İatrojenik damar yaralanmaları

Muzaffer Bahcivan, Mustafa Kemal Demirağ, Hasan Tahsin Keçeligil, Atilla Saraç, Hakan Karamustafa, Semih Murat Yücel, Ferşat Kolbakır
Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Samsun

İatrojenik nedenlerle meydana gelen damarsal (vasküler) yaralanmalar ve bunlara yönelik uygulanan cerrahi girişimler retrospektif olarak değerlendirildi.
1984-2004 yılları arasında, 52 olgu iatrojenik damar yaralanmaları sebebiyle ameliyat edildi. Otuzüçü erkek ve ondokuzu kadın olan hastaların yaş ortalaması 52 idi. Damarsal yaralanma, 45 hastada kardiyak kateterizasyon girişimi, 4 hastada çevrel (periferik) anjiografi girişimi, 3 hastada ise arteryel kanülasyon girişimi sonrası meydana geldi. 29 hastada tromboz, 18 hastada rüptür ve kan toplağı (hematom), 2 olguda yalancı (pseudo) anevrizma, 2 olguda stent girişimi sonrası sol ön inen (LAD) arter rüptürü, 1 olguda ise yine stent girişimi sonrası sirkumfleks (CX) arterde diseksiyon tespit edildi. 28 hastaya embolektomi, 14 olguya kan toplağı boşaltılması ve damarın birincil onarımı, 2 hastada yalancı-anevrizmanın eksizyonu, 2 olguda LAD arter ve 1 olguda CX arter onarımı, 3 olguya soldan sağa femoro-femoral yangeçit (baypas), 2 olguda da iliofemoral yangeçit operasyonu uygulandı.
Kalp kateterizasyonu girişimi, damarsal yaralanmaya neden olan en sık prosedürdü (% 86.53). Yaralanmanın en sık görüldüğü damarsal yapı sağ femoral atardamardı (% 55.76). İki hastada diz üstü ve 1 hastada total kalça dezartikülasyonu olmak üzere 3 hastaya amputasyon uygulandı (% 5.7). Diğer hastalar tamamen iyileşti.
İatrojenik damar yaralanmaları, erken tanı konulduğu taktirde, düşük mortalite ve morbidite oranları ile tedavi edilebilirler.

Anahtar Kelimeler: İatrojenik damarsal yaralanmalar, kateterizasyon, embolektomi, amputasyon


Muzaffer Bahcivan, Mustafa Kemal Demirağ, Hasan Tahsin Keçeligil, Atilla Saraç, Hakan Karamustafa, Semih Murat Yücel, Ferşat Kolbakır. Iatrogenic vascular injuries. Medeniyet Med J. 2005; 20(1): 38-41

Corresponding Author: Hasan Tahsin Keçeligil, Türkiye


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