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OP-043 Single surgeon multi-center experience in vascular injuries in the paediatric age group
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  1. Emrah Şişli
  1. Section of Paediatric Cardiovascular Surgery, Department of Cardiovascular Surgery, Osmangazi University Faculty of Medicine, Eskişehir, Turkey

Abstract

Aim The aim of this study is to evaluate the clinical characteristics of the patients with vascular injury, and the effect of the graft material used on the outcome.

Material and Method In this retrospectively designed study, clinical data of cases with vascular injury under the age of 18, operated by a surgeon in three different centers between 2017 and 2023, were obtained.

Results Among 77 patients, the median agewas 14 years (7 months - 18 years). 59 (76.6%) patients were male. Demographic and clinical data of the patients are presented in table 1. The lower extremity was the most common trauma site (n=69, 89.6%). There were 70 (90.9) artery and 22 (28.6%) vein, and 15 (19.5%) both artery and vein injuries. Graft use was lower in cases with penetrating trauma such as glass cuts or stab injuries (p<0.001). The surgical technique and the distribution of the graft material used are shown in figure 1A-B. Ischemia time, hospital stay and mortality rate were higher in the graft group (p<0.001, p<0.001, p=0.040, respectively). While mortality was observed in three (3.9%) patients, it was higher in the graft group (p = 0.040). The mean follow-up duration was 29.8±15.9 months. During the follow-up period, the graft was patent in 59 (76.6%) and occluded in 18 (23.4%) patents (figure 1C, p=0.008). The vascular patency rate of all cases over time is shown in figure 1D. The patency rate was higher in cases where no graft was used (Mantel-Cox, Ӽ2=7.04, p=0.008, figure 1E). The best and worst patency rates were found in the autologous saphenous vein and Dacron grafts, respectively (Ӽ2=26.9, p<0.001, figure 1F).

Conclusions Although traumatic extremity injuries are at the forefront of vascular injuries in childhood, it is important to avoid the use of grafts as much as possible, except for autologous saphenous vein, to ensure longer-term vascular patency.

Abstract OP-043 Figure 1

Surgical and follow-up characteristics of all cases. Bar graphs show the distribution of the graft material used in vessel revascularization. (A), the surgical technique applied (B), and the relationship between the patency of graft use (C). Kaplan-Meier survival chart (D) shows vascular patency over time in all cases and Kaplan-Meier survival chart (E) shows the significant effect of graft use on vascular patency over time.

Abstract OP-043 Table 1

Demographic and clinical characteristics of the cases included in the study.

  • Vascular repair
  • Vascular injury
  • Paediatric age
  • Trauma
  • Graft material

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