Rich’s Vascular Trauma

Australia and New Zealand

Region-Specific Epidemiology Australia and New Zealand have a combined population of approximately 30 million people (approximately the population of Texas) spread over a very large land mass of nearly 8 million square kilometers (roughly the size of the continental United…

Vascular Surgery in the Austere Environment

Introduction Vascular surgery is normally conducted in a highly technical environment with a full complement of specialized equipment including noninvasive ultrasound technology, state-of-the-art computed tomography (CT), modern fluoroscopy, specialized instruments for open surgery, and postoperative intensive care units and wards…

Management of Pediatric Vascular Injury

Introduction In the United States, injuries account for approximately 10,000 childhood fatalities every year. Unintentional injury results in one in four pediatric medical visits, and the direct cost of these injuries is estimated to be over $50 billion annually. Vascular…

Considerations for Conduit Repair of Vascular Injury

Introduction In 1949, Jean Kunlin performed the first saphenous vein bypass in the lower extremity of a patient suffering from ischemia. The work was not the result of chance alone as his predecessors in vascular surgery had been working on…

Surgical Damage Control and Temporary Vascular Shunts

Introduction Since the turn of the century, there have been major changes in the management of the severely injured patient. Perhaps most notable is the adoption of damage control or staged procedures. Stone and colleagues provided the landmark description of…

Lower Extremity Vascular Trauma

Introduction and Scope In this chapter we present the workup and surgical management of vascular trauma to the lower extremities spanning from the common femoral vessels in the groin to the tibial vasculature at the ankle. The term “vascular injury”…

Upper Extremity and Junctional Zone Injuries

Epidemiology of Upper Extremity Vascular Injury Reports from civilian and military settings have shown the distribution and outcomes of major vascular injuries going as far back as the Civil War ( Table 21.1 ). Although some publications comment on and…

Neck and Thoracic Outlet

Introduction Perhaps no other anatomic region contains so many vital structures in such a compact space as the neck and thoracic outlet. Injuries in this region can result in hemorrhage, stroke, upper and/or lower extremity paralysis, loss of airway, and…

Inferior Vena Cava, Portal, and Mesenteric Venous Systems

Introduction Injury to the large veins of the abdominal cavity, including the inferior vena cava (IVC) and the portal and the superior mesenteric veins is uncommon occurring in 5% of penetrating and 1% of blunt trauma cases. Because prehospital mortality…