Risk Factors in Pediatric Blunt Cervical Vascular Injury and Significance of Seatbelt Sign

(1) Background: survivors of allogeneic hematopoietic cell transplantation (alloHCT) suffer from morbidity and mortality due to cardiovascular events. We hypothesized that vascular injury and pro-coagulant activity are evident in alloHCT survivors without existing alloHCT complications or relapse. (2) Methods: we enrolled consecutive adult alloHCT survivors without established cardiovascular disease and control individuals matched for traditional cardiovascular risk factors (January–December 2019). Circulating microvesicles (MVs) of different cellular origins (platelet, erythrocyte, and endothelial) were measured by a standardized flow cytometry protocol as novel markers of vascular injury and pro-coagulant activity. (3) Results: we recruited 45 survivors after a median of 2.3 (range 1.1–13.2) years from alloHCT, and 45 controls. The majority of patients suffered from acute (44%) and/or chronic (66%) graft-versus-host disease (GVHD). Although the two groups were matched for traditional cardiovascular risk factors, alloHCT survivors showed significantly increased platelet and erythrocyte MVs compared to controls. Within alloHCT survivors, erythrocyte MVs were significantly increased in patients with a previous history of thrombotic microangiopathy. Interestingly, endothelial MVs were significantly increased only in alloHCT recipients of a myeloablative conditioning. Furthermore, MVs of different origins showed a positive association with each other. (4) Conclusions: endothelial dysfunction and increased thrombotic risk are evident in alloHCT recipients long after alloHCT, independently of traditional cardiovascular risk factors. An apparent synergism of these pathophysiological processes may be strongly involved in the subsequent establishment of cardiovascular disease.

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Blunt Cervical Vascular Injury

Neurotrauma ◽

10.1093/med/9780190936259.003.0014 ◽

2019 ◽

pp. 121-128

Author(s):

Aaron R. Plitt ◽

Benjamin Kafka ◽

Kim Rickert

Keyword(s):

Cervical Spine ◽

Vascular Injury ◽

Anticoagulation Therapy ◽

Imaging Study ◽

Neck Region ◽

Vascular Imaging ◽

Spine Fractures ◽

Cerebrovascular Injury ◽

Cervical Spine Fractures ◽

Blunt Cervical Vascular Injury

Cervical cerebrovascular injury occurs in approximately 1% of patients presenting with blunt trauma, but it carries a high morbidity (80%) and mortality (40%) when left undiagnosed. Cervical spine fractures, especially between C1 and C6, are at higher risk for injury to the cervical cerebrovasculature. These injuries are graded I–V in order of ascending severity. The diagnosis is established using a vascular imaging study, predominantly CT angiography. Once diagnosed, the treatment is predominantly medical with antiplatelet or anticoagulation therapy, and its presence should not preclude reduction of a fractured or subluxed vertebrae. The medical therapy should be continued for 3–6 months with regular follow-up vascular imaging to assess for progression of the injury. Overall, blunt cervical vascular injury should be suspected in patients with cervical spine fractures or trauma to the head and neck region, and it should be treated medically.

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Blunt Cervical Vascular Injury

Vascular Trauma ◽

10.1016/b978-0-7216-4071-6.50018-8 ◽

2004 ◽

pp. 241-250

Author(s):

Walter L. Biffl ◽

Ernest E. Moore ◽

Jon M. Burch

Keyword(s):

Vascular Injury ◽

Blunt Cervical Vascular Injury

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Faculty Opinions recommendation of Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14092.471595 ◽

2006 ◽

Author(s):

Craig Blackmore

Keyword(s):

Vascular Injury ◽

Computed Tomographic Angiography ◽

Computed Tomographic ◽

Tomographic Angiography ◽

Blunt Cervical Vascular Injury

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Single centre experience of combat-related vascular injury in victims of Syrian conflict: Retrospective evaluation of risk factors associated with amputation

Injury ◽

10.1016/j.injury.2016.03.030 ◽

2016 ◽

Vol 47 (9) ◽

pp. 1945-1950 ◽

Cited By ~ 3

Author(s):

Emrah Şişli ◽

Ali Aycan Kavala ◽

Mustafa Mavi ◽

Osman Nejat Sarıosmanoğlu ◽

Öztekin Oto

Keyword(s):

Risk Factors ◽

Vascular Injury ◽

Retrospective Evaluation ◽

Single Centre ◽

Factors Associated ◽

Single Centre Experience ◽

Syrian Conflict

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Relationship Between Femur and Femoral Arteries for Identifying Risk Factors for Vascular Injury

Medical Science Monitor ◽

10.12659/msm.900252 ◽

2017 ◽

Vol 23 ◽

pp. 1733-1740 ◽

Cited By ~ 3

Author(s):

Qi Sun ◽

GuoXin Fan ◽

XiFan Li ◽

JinPeng Gong ◽

Wei Ge ◽

...

Keyword(s):

Risk Factors ◽

Vascular Injury ◽

Femoral Arteries

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CTA-Based Screening Reduces Time to Diagnosis and Stroke Rate in Blunt Cervical Vascular Injury

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e3181b84408 ◽

2009 ◽

Vol 67 (3) ◽

pp. 551-556 ◽

Cited By ~ 79

Author(s):

Alexander L. Eastman ◽

Vijay Muraliraj ◽

Jason L. Sperry ◽

Joseph P. Minei

Keyword(s):

Vascular Injury ◽

Stroke Rate ◽

Time To Diagnosis ◽

Blunt Cervical Vascular Injury

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Treatment of Phalangeal Fractures in Severely Injured Hands

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2000.0486 ◽

2001 ◽

Vol 26 (2) ◽

pp. 108-111 ◽

Cited By ~ 18

Author(s):

F. J. T. VAN OOSTEROM ◽

G. J. V. BRETE ◽

C. OZDEMIR ◽

S. E. R. HOVIUS

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Bone Loss ◽

Vascular Injury ◽

Statistical Correlation ◽

Severely Injured ◽

Infection Rates ◽

Segmental Bone ◽

Phalangeal Fractures

This retrospective study was performed to assess the incidence of complications of operative treatment of phalangeal fractures. Risk factors for the development of complications were also investigated. Records and radiographs of 350 patients with 666 operatively treated phalangeal fractures were studied. Minimum follow-up was 1 year. A total of 176 fractured fingers were amputated primarily or secondarily, leaving 490 fractures for follow-up. Ninety-three fractures were treated conservatively. Nonunion necessitating reoperation developed in 6% (31/490) of fractures, malunion in 9% (44/490) and infection in 2% (8/490). Infection, segmental bone loss and (neuro)vascular injury predisposed to nonunion and replantation predisposed to malunion. There was a statistical correlation between the use of external fixation and malunion. Nonunion, malunion, and infection rates were similar to other studies.

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The effect of aromatase inhibitors use on endothelial function among postmenopausal women with breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e12064 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e12064-e12064

Author(s):

Ronny Maor ◽

Elad Maor ◽

Amanda Wanous ◽

Sandhya Pruthi ◽

Amir Lerman ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Endothelial Function ◽

Postmenopausal Women ◽

Aromatase Inhibitors ◽

Vascular Injury ◽

Statistical Difference ◽

Control Group ◽

Increased Risk

e12064 Background: Data on long-term cardiovascular effects and safety of aromatase inhibitors (AI) are limited and conflicting. The purpose of the current study was to evaluate the effect of AI on vascular injury as assessed by peripheral endothelial function among women with breast cancer. Methods: This is an observational, prospective study of 96 postmenopausal women with breast cancer at initiation of treatment, with or without AI. All participants underwent baseline and 6-12 months follow up non-invasive peripheral endothelial function measurement. Reactive hyperemia index (RHI) was measured using the EndoPAT test. The primary endpoint was endothelial function deterioration of at least 20% between baseline and follow-up. Results: Mean age of the study population was 66±7 years. There was no statistical difference in demographic data between the groups. Compared with the control group, more women in the treatment group demonstrated worsening of RHI (53% vs. 42%, p = 0.207) between baseline and 6-12 month follow up measurement. There was no statistical difference between the groups at baseline. When RHI deterioration was evaluated as a dichotomous variable, with a 20% cutoff, women in the AI group demonstrated higher rates of RHI deterioration (28% vs. 8%, p=0.020). The risk of AIs for endothelial dysfunction was correlated with burden of cardiovascular (CV) risk, such that in women with >3 CV risk factors, AIs were associated with increased risk of RHI deterioration (42% vs. 10%, p=0.016), whereas in women with <2 CV risk factors, rates of RHI deterioration were similar in AI and control groups (20% vs. 7%, p = 0.232). Conclusions: This study suggests that AI therapy may be associated with vascular injury as detected by deterioration in endothelial function. The effect is more pronounced among women with higher baseline CV risk factor burden. The results of this study have potentially important implications for patients with breast cancer being treated with AI and for women at increased lifetime risk of breast cancer who may use AI for breast cancer risk reduction. Clinical trial information: NCT00719966.

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