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Rate of vascular injury in Afghanistan conflict higher than in previous wars
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Among U.S. service members with battle-related injuries from the war in Afghanistan, the rate of vascular injury is higher compared with previous wars, researchers reported at the Society for Vascular Surgery Vascular Annual Meeting.
Although most vascular injuries required open repair or ligation, in 8% of cases, endovascular techniques were used to perform definitive repair, Jigarkumar Patel, MD, vascular surgery fellow at Walter Reed National Military Medical Center, said during a presentation.
Patel and colleagues analyzed 685 service members with battle-related vascular injuries who survived to be treated at a surgical facility in Afghanistan between 2009 and 2015.
The 685 patients represented 17.6% of all service members with battle-related injuries treated during the study period, and they had 1,105 vascular injuries, or 1.6 per patient, according to the researchers.
Most of the vascular injuries were related to extremity trauma (72%), whereas 17% were related to the torso region and 11% were related to the cervical region.
Among the vascular injuries, 45% were in the lower extremities.
Seventy percent of the vascular injuries were caused by explosions with shrapnel penetration, whereas 30% were from gunshot wounds, according to the researchers.
Open repair was performed in 54% of procedures, ligation in 38% and endovascular repair in 8%, according to Patel and colleagues. In 376 cases, diagnostic angiography was performed.
The cohort had a 5% mortality rate.
“The rate of vascular injury in modern combat is higher than that reported in previous wars. Open reconstruction is performed in half of cases, although ligation is an important damage control option — especially for minor or distal vessel injuries,” Patel and colleagues wrote in an abstract. “Diagnostic angiography is common and endovascular methods of repair are now used in nearly 10% of cases. Proficiency with open and endovascular methods of vascular injury management remains a critical need for the U.S. military and will require partnership with civilian institutions to attain and maintain.” – by Erik Swain
Reference:
Patel J, et al. S7: Scientific Session 7. Presented at: Society for Vascular Surgery Vascular Annual Meeting; June 20-23, 2018; Boston.
Disclosure: Patel reports no relevant financial disclosures.