Traumatismos vasculares revisão de 5 anos*

 

Luís F. Antunes, Ana Baptista, Joana Moreira, Ricardo Pereira, Anabela Gonçalves, Gabriel Anacleto, João Alegrio, Manuel Fonseca, Óscar Gonçalves, Albuquerque Matos

Serviço de Angiologia e Cirurgia Vascular, Hospitais da Universidade de Coimbra E-mail: luisffantunes@yahoo.com

 

|RESUMO|

O presente trabalho pretende avaliar a casuística dos traumatismos vasculares agudos admitidos no Serviço de Cirurgia Vascular dos Hospitais da Universidade de Coimbra (HUC) durante o período de 5 anos, compreendido entre Julho de 2004 e Junho de 2009. Foram avaliados 97 doentes, sendo a principal causa de traumatismo as lesões iatrogénicas, seguida dos acidentes de viação. No grupo de doentes não relacionados com procedimentos coronários percutâneos verificou-se que no membro superior as artérias umeral e radial foram as mais afectadas, enquanto no membro inferior foram as artérias femoral superficial e poplítea. A isquémia aguda foi a principal forma de apresentação. Relativamente ao tratamento deste grupo de doentes, a RATT (ressecção e anastomose topo-topo) e o enxerto foram os mais utlizados no membro superior, enquanto a trombectomia e o bypass foram as técnicas mais aplicadas a nível do membro inferior. Não houve mortalidade mas a morbilidade foi elevada, predominando as lesões neurológicas nos traumatismos do membro superior, e a amputação nos do membro inferior. Os resultados deste trabalho foram concordantes com o que está publicado na literatura em que se demonstra um aumento progressivo dos traumatismos de origem iatrogénica.

Palavras-chave: traumatismos vasculares, iatrogenia, acidentes de viação, lesões neurológicas, amputação

 

Vascular Trauma a five year review

|ABSTRACT|

This review intended to evaluate the series of acute vascular trauma in the Vascular Surgery Service of the Coimbra University Hospital in the period between July 2004 and June 2009. A total of 97 patients were evaluated with iatrogenic lesions being the main cause of trauma injuries, followed by traffic accidents. In group of patients not related with percutaneous coronary angioplasty, it was found that brachial and radial arteries were the most affected in upper limb, while in the lower limb were the superficial femoral and popliteal arteries. The main clinical manifestation was acute ischemic limb. In this group, resection with end-to-end anastomosis and grafts were the main treatment in the upper limb, while trombectomy and bypass were the most common applied technique in the lower limb. There were no deaths, but morbidity was high. Neurologic lesions were more frequent in upper limb and amputation in lower limb. These outcomes were similar to other results reported in the literature which demonstrates a gradual increase in iatrogenic injuries.

Key words: vascular trauma, iatrogenic, traffic accident, neurologic lesions, amputation

 

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*Apresentado sob a forma de comunicação oral no X Congresso Anual da SPACV, 2010