Non-iatrogenic civilian vascular trauma in a well-defined geographical region in Finland

The purpose of this study was to assess the incidence, treatment and outcome of vascular trauma in a well-defined geographical region in Finland.

A retrospective analysis was conducted of patients admitted to Tampere University Hospital (TAUH), Pirkanmaa, Finland, due to vascular trauma between January 2006 and December 2010. Data regarding trauma mechanism, anatomical location, treatment, and short-term outcome were collected from patients’ files and vascular register.

Altogether, 143 non-iatrogenic vascular traumas occurred during the study period resulting in an annual trauma incidence of 5.8/100,000/year in the TAUH region. The majority of the injuries were located in the upper extremities (N = 83, 58 %). Penetrating injuries comprised 58 % (83 patients) of all vascular trauma admissions and were significantly more common among men compared to women (83 and 17 %, respectively). The majority (N = 93, 65 %) of the injuries were treated surgically, while in 15 (11 %) patients the trauma was resolved by endovascular means. The remaining 35 (24 %) patients were successfully managed conservatively, i.e., by observation or wound exploration only without the need for later (30-day) vascular repair. Two out of 17 patients (12 %) with lower extremity vascular trauma required major amputation. Procedure-related complications occurred in five patients. In-hospital and 30-day mortality was zero.

This paper demonstrates that the incidence of non-iatrogenic civilian vascular trauma in the Pirkanmaa region is low and mainly caused by penetrating injury. Further, the majority of vascular traumas are still treated surgically. In general, the short-term survival of patients who survive the initial trauma is good.