Department of Vascular Surgery, University Hospitals of Birmingham NHS Foundation Trust, Birmingham, UK; Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Vascular Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK.
Ann Vasc Surg. 2024 Feb;99:448-452. doi: 10.1016/j.avsg.2023.09.083. Epub 2023 Nov 7.
The experience in pediatric vascular diseases is limited in the United Kingdom and worldwide due to their rarity and variations in practice. We looked at types of cases presenting to a dedicated pediatric vascular clinic.
Medical records of children seen in a dedicated pediatric vascular clinic at a tertiary referral service between 2016 and 2022 were reviewed. These patients were either seen for the first time in that clinic or had their appointments as a follow-up after inpatient review or intervention while being under the care of pediatric teams in local hospitals.
Fifty-five patients (34 males) were seen aged between 4 months and 17 years (mean 9.5 years). Common presentations were limb length discrepancy secondary to iatrogenic arterial occlusion, follow-up after bypass for trauma, lower limb swelling or discoloration, and varicose veins. Operative procedures included lower limb bypass, angioplasty, ligation of aneurysms, and varicose vein surgery.
Pediatric vascular conditions are uncommon and therefore most vascular surgeons and trainees will have little exposure to such cases. Intervention is needed for arterial injury secondary to penetrating or iatrogenic trauma. A national registry is required for these rare cases to gain prospective data that can help build up more evidence for educational purposes and to establish guidelines.
由于儿科血管疾病的罕见性和实践中的差异,英国和全球范围内的儿科血管疾病经验有限。我们研究了专门的儿科血管诊所就诊的病例类型。
对 2016 年至 2022 年在三级转诊服务的专门儿科血管诊所就诊的儿童的医疗记录进行了回顾。这些患者要么是在该诊所首次就诊,要么是在住院治疗或干预后作为随访预约,同时由当地医院的儿科团队进行护理。
55 名患者(34 名男性)的年龄在 4 个月至 17 岁之间(平均 9.5 岁)。常见的表现为医源性动脉闭塞引起的肢体长度差异、创伤后旁路手术后的随访、下肢肿胀或变色以及静脉曲张。手术包括下肢旁路、血管成形术、动脉瘤结扎和静脉曲张手术。
儿科血管疾病并不常见,因此大多数血管外科医生和受训者对这些病例的接触机会较少。需要对穿透性或医源性创伤引起的动脉损伤进行干预。需要为这些罕见病例建立国家登记处,以获取有助于建立教育目的更多证据和指南的前瞻性数据。