Peripheral arterial trauma in children. A fifteen year review.

A 15 year retrospective evaluation of peripheral vascular trauma in infants and children was undertaken. Forty-eight affected limbs in 47 patients (mean age 5.1 years) were explored for peripheral arterial injury. There were 40 iatrogenic, five penetrating and three blunt injuries. Thrombectomy alone, thrombectomy with autogenous saphenous vein patch angioplasty, direct angioplasty, segmental resection with end-to-end anastomosis and interposition-bypass grafting were the most common reparative procedures used. Circulation was normal within 24 hours of surgery in 35 of the 45 limbs (77.8%) whose patency was restored. In patients less than three years or 12.5 kg with iatrogenic injuries, patency rate was significantly lower (p 0.05). Four children died of congenital heart disease. All six children with failed vascular reconstruction suffered late sequelae.