Arterial Iatrogenic Injuries

Outside of the liver and kidneys, there are innumerable other types of iatrogenic arterial injuries that can occur. Of course the commonest iatrogenic injury is post-catheterization femoral artery pseudoaneurysms, but this is discussed in another chapter. 

Since vessels can be injured anywhere in the body, it is not possible to discuss the specific anatomy of all arterial beds. But there are some general anatomic assessments common to all regions and questions that must be answered prior to treating an iatrogenic vascular injury. 

Mariano RT, Stein B, Vine HS, Rosshirt W, Sussman SK, Ohki SK (2000) Angiographic diagnosis and transarterial embolization of iatrogenic ovarian artery injury. J Vase Interv Radiol 11 625-628... 

Kwon JH, Kim GS (2002) Obstetric iatrogenic arterial injuries of the uterus diagnosis with US and treatment with transcatheter arterial embolization. Radiographics 2235-46... 

Schwartz RA, Kerns DB, Mitchell DG (1991) Color Doppler ultrasound imaging in iatrogenic arterial injuries. Am J... 

US and Doppler techniques are accurate means to diagnose injuries to the femoral vessels in the groin. These usually occur as a result of iatrogenic procedures (arterial catheterization), but may also be involved in displaced fractures of the pubis and the femoral neck, crush injuries, blunt trauma and so forth. The most common site for arterial injuries is the common and proximal superficial femoral artery. The main complication is a pseudoaneurysm. Other less frequent complications include thrombosis, arteriovenous fistula, dissection, intimal flaps and perivascular hematoma. Pseudoaneurysms of the femoral artery follow a tear of the vessel wall followed by leakage of blood from the artery into the adjacent tissue and usually appear as pulsatile well-defined anechoic masses located closely to the artery (Fig. 12.41). Mural thrombus is often present and partially fills the pseudoaneurysm sac. Blood flow inside the pseudoaneurysm is typically swirling with alternating red and... 

---