Surgical outcomes of peripheral vascular trauma in pediatric patients at the Cardiovascular and Thoracic Center, Viet Duc University Hospital

Objective: To describe the diagnostic features, surgical methods, and outcomes of peripheral vascular injury management in pediatric patients. Methods: A retrospective cross-sectional study was conducted on all patients under 16 years of age who underwent surgery with an intraoperative diagnosis of peripheral vascular injury due to trauma (including vasospasm, vascular contusion, and thrombosis) at the Cardiovascular and Thoracic Center, Viet Duc University Hospital, from January 2021 to December 2024. Results: Among the 35 pediatric patients, 23 (65.7%) sustained upper limb injuries, while 12 (34.3%) had lower limb injuries. The predominant mechanism of trauma was domestic accidents (primarily unassisted falls), accounting for 24 cases (68.5%), followed by traffic accidents (n = 10, 28.6%) and one case (2.9%) of occupational injury. All patients had at least one limb fracture, including 26 closed fractures (74.3%) and 9 open fractures (25.7%). A total of 30 patients (85.7%) showed no signs of acute ischemic syndrome. Regarding treatment, intraoperative pathological findings suggestive of vascular spasm were observed in 27 cases (77.1%). Among them, five patients (14.3%) received topical papaverine to induce vasodilation, while 22 (62.9%) required arterial dilatation using a Fogarty catheter. Four patients (11.4%) with arterial contusions were treated with end-to-end anastomosis, and another four (11.4%) underwent vascular reconstruction using reversed saphenous vein grafts. One patient (2.9%) developed postoperative complications, including infection and thrombosis, requiring reoperation and vascular repair using a saphenous vein homograft. Conclusion: Vascular trauma presents significant challenges in pediatric cases. Vascular surgeons must consider the patient’s future growth potential when planning interventions. Early diagnosis and timely treatment by experienced vascular surgeons at high-volume surgical centers can help reduce mortality and limb amputation rates.