Iatrogenic vascular injury. A reducible problem.

During a six-year period 46 patients were treated for iatrogenic vascular injuries at the University of Texas Health Science Center, San Antonio. Diagnostic procedures led to 24 injuries, while therapeutic procedures were responsible for 22 vascular injuries. Trauma to the brachial and femoral arteries and the subclavian vein accounted for the majority of injuries. The most frequently encountered injuries were intimal tear, thrombosis, and laceration. Lateral suture, thrombectomy, and intimal repair were the most commonly employed forms of vascular repair. Postoperative complications were not related to the vascular injuries. Conclusions drawn from this review were as follows: (1) most injuries occur in nonsurgical areas of the hospital; (2) most injuries are related to improper placement, use, or manipulation of catheters; (3) mortality in these cases is caused by the underlying disease process; and (4) long-term sequelae secondary to the vascular injuries are rare.