Treatment and results of iatrogenic vascular lesions

The incidence and etiology of iatrogen vascular injuries have changed durin g the last years due to the fact that many Vascular procedures, including i nvasive catheter procedures, minimally invasive interventions and osteosynt hetic operations are more frequently performed. 66 patients who were treate d between 1993 and 1997 were retrospectively analysed. The most common caus e of surgical repair were lesions after catheter procedures (n = 47, 71.2 % ) followed by various other causes (traumatology n = 6, orthopedics n = 5, gynecology n = 4, general surgery n = 4). In patients with complicated cath eterizations and need for acute vascular-surgical repair, the: limb could o nly be preserved in 12 of 21 cases (57.1 %). Vascular lesions on account of other operative specialities finally required an amputation in 3 patients. One patient in this group died. Besides the seriousness of injury one main reason for an unfavourable outcome was a delayed diagnosis with subsequent exceeding of the ischemic tolerance in 18 patients (27.3 %). Some rare and serious complications are especially discussed.