Padovani J P, Rigault P, Mouterde P
Chir Pediatr. 1978;19(2):69-76.
The authors review 66 case reports of trauma involving major vessels of the limbs in children and confirm the seriousness of these lesions. It becomes apparent that iatrogenic lesions are quite frequent especially after arterial punctures and arteriographies in general. They stress the importance of clinical diagnosis in vascular blocks. Arteriography should be exceptionally used for infants. Management should aim at restoring vascular continuity by deobstruction, suture or vein grafting. The ideal solution is often easily obtained when repair is undertaken quickly. Normal blood flow was satisfactorily obtained in only 36 patients whereas poor results in the remaining cases was explained because of delayed action. Sequellae are severe and more frequently encountered when blood flow is not restored. On the other hand, the repercussions on growth and development of the limb after chronic ischemia is still not a proven fact. Finally, the authors underline the severe consequences of thromboses after arteriographies by femoral puncture in infants.
作者回顾了66例儿童四肢主要血管创伤的病例报告，并证实了这些损伤的严重性。很明显，医源性损伤相当常见，尤其是在动脉穿刺和一般的动脉造影术后。他们强调了血管阻塞临床诊断的重要性。动脉造影在婴儿中应特别慎用。治疗应旨在通过解除阻塞、缝合或静脉移植来恢复血管连续性。如果迅速进行修复，通常很容易找到理想的解决方案。只有36例患者获得了满意的正常血流，而其余病例结果不佳是因为治疗行动延迟。如果血流未恢复，后遗症会很严重且更常见。另一方面，慢性缺血后对肢体生长发育的影响仍未得到证实。最后，作者强调了婴儿股动脉穿刺动脉造影术后血栓形成的严重后果。
