1/34. Access to the traumatized vertebral artery: an unusual approach.Although injuries to the vertebral arteries are relatively uncommon, there are several different methods used to gain access to these vessels, and to control any bleeding arising from them. We describe a case of torrential oropharyngeal bleeding following a stab wound to the neck in which rapid access to the vertebral artery was gained using a paramedian mandibulotomy; this approach has not previously been documented. The other approaches are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/34. Penetrating thoracic trauma in arrow injuries.Arrow wounds are very rare. We present herein a case of hilar penetrating thoracic trauma caused by an arrow, and a review of the literature, to clarify the management of these cases and their indications for surgery. Depending on the type of arrowhead, the tissue elasticity can narrow the wound track around the shaft of the arrow, sometimes causing a tamponade effect. In the mediastinal or hilar area, an arrow should not be removed before an injury to the major blood vessels or the heart has been ruled out.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/34. Traumatic pseudoaneurysm of the thyrocervical trunk.A case of a pseudoaneurysm of the thyrocervical trunk after a pocketknife stab wound to zone I of the neck is reported. The patient was evaluated and treated in an emergency department with irrigation of the wound, bandage, and oral antibiotics. A large pseudoaneurysm slowly developed over the next 2 months. When the patient arrived at our hospital, he was immediately admitted and arteriograms were obtained. Arteriograms revealed an active leak of blood into a pseudoaneurysm from the thyrocervical trunk. Surgical treatment consisted of proximal and distal ligation of the thyrocervical trunk. This is the first case of a pseudoaneurysm developing only from the thyrocervical trunk due to a stab wound to zone I of the neck. This case and its complication serve to illustrate and emphasize the rationale for routinely imaging the great vessels after all penetrating trauma to zone I of the neck.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/34. Traditional punishment and unexpected death in Central australia.Three cases of traditional punishment in Central Australian Aboriginal men are presented in which the thighs were speared or stabbed as part of a "payback" system. In two cases, an unexpected effect of the stabbing or spearing was death due to severing of major leg vessels. The relationship between customary Aboriginal law and general law in australia has not been clearly defined; however, these cases demonstrate that significant and untoward effects may result from traditional punishments. Pathologists working near traditional Australian Aboriginal communities may still encounter such injuries at autopsy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/34. suicide by more than 90 stab wounds including perforation of the skull.A man committed suicide in his bathroom using a small pocket knife. At the autopsy a total of 92 stab wounds on the forehead, in both temples, the anterior aspect of the neck, the back of the neck, the chest and the sides of the trunk were found. In addition, repeated stabbing had caused a large soft tissue defect on the forehead. The frontal bone showed 3 perforations but no brain injury was present and two ribs were severed in the bony part, one of which carried a star-like pattern from repeated stabbing. No major vessels were injured and the cause of death was exsanguination after a considerable survival time. The large number of stab wounds, the perforation of bone and some injury sites, especially the head and back of the neck, are extraordinary findings in suicides which were probably favoured by insufficient anatomical knowledge and the use of a short-bladed knife. A psychiatric history could not be verified.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/34. Successful surgical management of complete tracheal disruption due to penetrating injury.Successful management of penetrating injury to the trachea is rare, especially in japan. A 32-year-old female attempted suicide by stabbing herself in the throat with a knife, and at operation the trachea was found to be completely disrupted. A median sternotomy made possible end-to-end anastomosis of the trachea. All other important organs including the great vessels, esophagus, and lungs were intact, but the pleura was open on the right side. The patient was managed under heavy sedation and with controlled ventilation for more than a week postoperatively, because of her suspected mental condition. She was extubated on postoperative day 13 and transferred to a mental hospital on day 16. We concluded that early diagnosis and surgical repair were important for the successful management of this patient with tracheal disruption.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/34. Covered stent-graft repair of the brachiocephalic arteries: technical note.OBJECTIVE: The use of a covered stent-graft to repair disruptions of the cervical carotid and vertebral arteries is described. This device maintains vessel patency while effectively excluding pseudoaneurysms, arteriovenous fistulae, and other breaches in the integrity of the arterial wall. methods: Patient 1 bled from a large rent in the proximal common carotid artery as a result of tumor invasion. Patient 2 developed a vertebral arteriovenous fistula after a stab injury to the neck. Patient 3 developed cerebral infarction and an enlarging pseudoaneurysm of the internal carotid artery, also after a stab wound to the neck. RESULTS: All three patients were treated with the Wallgraft endoprosthesis (boston Scientific, Watertown, MA). In each case, the vessel wall defect was repaired while antegrade flow through the artery was preserved or restored. No neurological complications occurred as a result of stent-graft deployment. CONCLUSION: Covered stent-grafts offer an alternative to endovascular occlusion of the parent vessel, thereby expanding the therapeutic options for patients with extracranial cerebrovascular disease. These three cases highlight the usefulness and versatility of these devices for endoluminal reconstruction of the brachiocephalic vasculature.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
8/34. axillary artery injury: report of two cases and review of the literature.These are the cases of two young men, 21- and 28-year old, who sustained penetrating stab injuries to their axillary arteries. Both patients presented initially with profuse bleeding and were in a state of shock. The first patient underwent initial emergency surgery to control his bleeding whereby deep stitches were inserted around the axillary vessels and nerves and ended up with permanent iatrogenic median nerve palsy. The bleeding in the second patient was controlled initially by compression dressing and he underwent successful vascular repair of the axillary artery with full recovery of his upper limb function. In this paper, we are discussing the initial management problem of these cases and the results of similar injuries and their repair in the literature.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/34. Traumatic arteriovenous fistula of ascending aorta and left innominate vein.We report a patient with a traumatic arteriovenous fistula between the ascending aorta and innominate vein, presenting 4 years after injury. diagnostic imaging and surgical management of this rare manifestation of thoracic great vessel injury is described.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/34. Traumatic pseudoaneurysm and high flow arteriovenous fistula involving internal jugular vein and common carotid artery. Treatment with covered stent and embolization.We describe the case of a 36-year-old man who presented following penetrating trauma to the neck. angiography demonstrated a high-flow arteriovenous fistula and large false aneurysm of the common carotid artery that also had contributions from branches of the external carotid artery and the thyrocervical trunk. This was treated with a combination of a covered endovascular stent placed in the common carotid artery and coil embolization of other small feeding vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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