scholarly journals Litrature Review Trauma Vascular

2021 ◽  
Vol 1 (12) ◽  
pp. 933-945
Author(s):  
Muhammad Hardi Tenggara

Vascular traumatic is trauma to the blood vessels caused by blunt injuries such as a hard impact or penetrating injuries such as sharp object injuries, penetrating bullet shots. Massive haemorrhage is the main cause of vascular trauma, resulting in death. Therefore, prompt treatment is needed to avoid other complications or even death due to uncontrolled bleeding. Vascular surgeons are the key to trauma injury patients, by controlling bleeding and vascular reconstruction, using aspects of open and endovascular surgical techniques. Diagnostic protocols are needed to identify injuries and consider the best tactics for surgical treatment of vascular injuries. Accurate, non-invasive diagnostic imaging techniques are key to this strategy. The aim of this review is to determine the optimal diagnostic imaging in patients with suspected vascular injury in the anatomic region and the method of treatment with retrospective or prospective data collection which is preferable to CT angiography compared to other methods. CT angiography can be declared the gold standard for diagnosing vascular injury in patients.

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Cheong J. Lee ◽  
Rory Loo ◽  
Max V. Wohlauer ◽  
Parag J. Patel

Abstract. Although management paradigms for certain arterial trauma, such as aortic injuries, have moved towards an endovascular approach, the application of endovascular techniques for the treatment of peripheral arterial injuries continues to be debated. In the realm of peripheral vascular trauma, popliteal arterial injuries remain a devastating condition with significant rates of limb loss. Expedient management is essential and surgical revascularization has been the gold standard. Initial clinical assessment of vascular injury is aided by readily available imaging techniques such as duplex ultrasonography and high resolution computed tomographic angiography. Conventional catheter based angiography, however, remain the gold standard in the determination of vascular injury. There are limited data examining the outcomes of endovascular techniques to address popliteal arterial injuries. In this review, we examine the imaging modalities and current approaches and data regarding endovascular techniques for the management popliteal arterial trauma.


2017 ◽  
Vol 13 (3) ◽  
pp. 357-362
Author(s):  
Bijay Sah ◽  
Krishna Gopal Shrestha ◽  
Kaushal Kishore Tiwari ◽  
Jayapal Reddy

Background & Objectives:Vascular injury diagnosis and management can be challenging and need expert clinical judgments. The current study aims to present diagnostic methods and management outcome in vascular injury patients attending our centre.Materials & Methods: The study  is a prospective study conducted during the study period of one and half years (From January 2015 to June 2016). Diagnosis of vascular injury was done by clinical examination, hand Doppler or in conjugation with duplex scan/CT Angiography. Primary vascular repair with end to end anastomosis was carried out whenever technically feasible; however, if it was not possible interposition reversed saphenous graft (SVG) was used to complete the repair.Results:Out of hundred cases of vascular injury, 77% were male and 23% female with a mean age of 35.18± 16.93 years. The majority of the cases 53% were diagnosed by duplex study followed by additional imaging by CT angiography in 30% cases and 17% cases were diagnosed only on clinical judgment. The main type of vascular injury was a complete transaction in 62% of cases followed by complex wall defect in 22%. The most common type of vascular reconstruction was end-end anastomosis in 76% of cases followed by ligation and haemostasis in 13% and reverse SVG graft repair in six percent of cases.Conclusion:The study concluded with the observation that early presentation, diagnosis and management including initial resuscitation and definitive multi-specialist surgical approach are paramount for excellent outcome after vascular injury.


2009 ◽  
Vol 5 (2) ◽  
pp. 15
Author(s):  
Wanda Acampa ◽  
Mario Petretta ◽  
Carmela Nappi ◽  
Alberto Cuocolo ◽  
◽  
...  

Many non-invasive imaging techniques are available for the evaluation of patients with known or suspected coronary heart disease. Among these, computed-tomography-based techniques allow the quantification of coronary atherosclerotic calcium and non-invasive imaging of coronary arteries, whereas nuclear cardiology is the most widely used non-invasive approach for the assessment of myocardial perfusion. The available single-photon-emission computed tomography flow agents are characterised by a cardiac uptake proportional to myocardial blood flow. In addition, different positron emission tomography tracers may be used for the quantitative measurement of myocardial blood flow and coronary flow reserve. Extensive research is being performed in the development of non-invasive coronary angiography and myocardial perfusion imaging using cardiac magnetic resonance. Finally, new multimodality imaging systems have recently been developed bringing together anatomical and functional information. This article provides a description of the available non-invasive imaging techniques in the assessment of coronary anatomy and myocardial perfusion in patients with known or suspected coronary heart disease.


2020 ◽  
Vol 26 (32) ◽  
pp. 3915-3927 ◽  
Author(s):  
Stefano Ballestri ◽  
Claudio Tana ◽  
Maria Di Girolamo ◽  
Maria Cristina Fontana ◽  
Mariano Capitelli ◽  
...  

: Nonalcoholic fatty liver disease (NAFLD) embraces histopathological entities ranging from the relatively benign simple steatosis to the progressive form nonalcoholic steatohepatitis (NASH), which is associated with fibrosis and an increased risk of progression to cirrhosis and hepatocellular carcinoma. NAFLD is the most common liver disease and is associated with extrahepatic comorbidities including a major cardiovascular disease burden. : The non-invasive diagnosis of NAFLD and the identification of subjects at risk of progressive liver disease and cardio-metabolic complications are key in implementing personalized treatment schedules and follow-up strategies. : In this review, we highlight the potential role of ultrasound semiquantitative scores for detecting and assessing steatosis severity, progression of NAFLD, and cardio-metabolic risk. : Ultrasonographic scores of fatty liver severity act as sensors of cardio-metabolic health and may assist in selecting patients to submit to second-line non-invasive imaging techniques and/or liver biopsy.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P34-P35 ◽  
Author(s):  
Michael S Morris

Objective 1) Better recognize pathophysiology of postoperative tonsillectomy hemorrhage. 2) Be able to better differentiate the different types of post-tonsillectomy hemorrhage based upon understanding the vascular physiology and adjust management accordingly. Methods Post-tonsillectomy complications in children and adults were reviewed. 7 cases of hemorrhage, including 5 deaths, were carefully reviewed. Patients ranged between 2–40 years of age. This represents the largest series of post-tonsillectomy deaths reported to date. All postoperative deaths were due to bleeding and cardiopulmonary arrest. Post-mortem analysis was undertaken on those patients. CT angiography was reviewed in one surviving patient and the utility of this type of scanning is discussed. Results Post-tonsillectomy bleeding is one of the most worrisome otolaryngology concerns. Patients with bleeding on postoperative days 2–3 reported episodic bleeding stopping spontaneously. In these patients, the episode of unobserved bleeding signaled a vascular spasm with a likehood of recurrence. When the bleeding recurred it was massive and occured in a uncontrolled setting, leading to a poor outcome. Vascular trauma and spasm is likely. Conclusions Postoperative tonsillectomy bleeding is better managed by differentiating those patients with early stage bleeding on postoperative days 2–3. Direct examination of the operative field is imperative. Ancillary testing including CT angiograpy is helpful in the evaluation.


Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3645
Author(s):  
Isabel Theresa Schobert ◽  
Lynn Jeanette Savic

With the increasing understanding of resistance mechanisms mediated by the metabolic reprogramming in cancer cells, there is a growing clinical interest in imaging technologies that allow for the non-invasive characterization of tumor metabolism and the interactions of cancer cells with the tumor microenvironment (TME) mediated through tumor metabolism. Specifically, tumor glycolysis and subsequent tissue acidosis in the realms of the Warburg effect may promote an immunosuppressive TME, causing a substantial barrier to the clinical efficacy of numerous immuno-oncologic treatments. Thus, imaging the varying individual compositions of the TME may provide a more accurate characterization of the individual tumor. This approach can help to identify the most suitable therapy for each individual patient and design new targeted treatment strategies that disable resistance mechanisms in liver cancer. This review article focuses on non-invasive positron-emission tomography (PET)- and MR-based imaging techniques that aim to visualize the crosstalk between tumor cells and their microenvironment in liver cancer mediated by tumor metabolism.


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