Pediatric vascular injuries management: single-center 10-years experience

Objectives: To analyze pediatric vascular injury patterns, the interventions performed, and subse-quent outcomes at a high-volume trauma center.Methods: This study is a retrospective review of pediatric patients, who were admitted to the Uni-versity Emergency Hospital between 2010 and 2020 with an International Classification 9th of Dis-eases –Revision code for a traumatic vascular injury (900.0 – 904.9). Results: During the study period, 217 patients (mean age 12± 6, 135 (62%) males) sustained vascu-lar injuries.. Upper extremity represented the most common site with 125/217 (58%) vascular inju-ries. Of these, 122 were arterial injury and three were venous injury. And, Primary arterial repair of 83/125 (66%) was the most common type of treatment in this group. No amputation was done in this group during follow up. Lower extremity was the next most common site with 59 (27%) vascu-lar injuries. Of these, 26 were arterial and 22 were venous injury. Iatrogenic injuries of lower ex-tremity accounted for 16 (7%) patients. Primary arterial repair was the most common treatment with 10/59 (17%) patients. Primary below knee amputation was done in two (1%) patients. One limb amputation was done in one threatened ischemic limb after wrong catheter insertion. Twenty-nine (13%) patients sustained head and neck vascular injuries. There were four arterial injuries and 23 venous injuries. Primary arterial repair was done in four (2%) patients. Venous ligation was done in 23 (11%) patients. One aortic injury and three inferior vena cava injury during neuroblastoma exci-sion was treated by primary surgical repair without complications. The mean follow-up was 31± 11 months. Conclusion: Pediatric vascular injuries occur most often in the extremities. Mechanism of injury has a role in type of arterial repair. Multidisciplinary team of vascular and orthopedic and plastic sur-geons with individualized decision according to presentation is the key for optimum outcome.