Vascular Trauma: Causes, Symptoms, and Treatment

Vascular trauma refers to any injury to blood vessels, including arteries, veins, and capillaries, caused by blunt or penetrating trauma. These injuries can lead to reduced blood flow, severe bleeding, and tissue damage, and may be life-threatening if not treated promptly. Early recognition and urgent specialist treatment are essential to prevent complications such as limb loss, organ damage, or death.

Symptoms of Vascular Trauma

Symptoms vary depending on the location and severity of injury. Common signs include:

• External signs: Active bleeding, swelling, bruising, or a pulsatile expanding hematoma near the injury site; sometimes a bruit (whooshing sound) over the wound.
• Signs of ischaemia (reduced blood flow): Pain, numbness, tingling, weakness, pale or cold skin, and weak or absent pulses beyond the injury.
• Systemic symptoms: Low blood pressure, rapid pulse, dizziness, fatigue, confusion, or loss of consciousness in severe blood loss.
• Complications: Compartment syndrome, blood clots, or tissue death (necrosis) if treatment is delayed.

Diagnosing Vascular Trauma

Accurate and timely diagnosis is critical to assess the extent of vascular injury and plan appropriate treatment:

• Physical examination: Assessment of bleeding, distal pulses, skin colour, temperature, capillary refill, and signs of ischaemia.
• Doppler ultrasound: Evaluates blood flow and vessel continuity.
• CT Angiography: Provides detailed imaging to pinpoint vessel damage, blockages, or leaks.
• X-ray / MRI: Helps detect fractures and associated soft tissue injuries.
• Conventional angiography: A dye-based minimally invasive test to map complex vascular injuries and guide endovascular treatment.

Treatment Options for Vascular Trauma

Treatment depends on the severity, location, and type of vascular injury. Prompt intervention is essential to restore blood flow, control bleeding, and preserve limb or organ function.

1. Emergency Management

• Direct pressure or dressings to control external bleeding.
• Immobilisation of the injured limb or region.
• Intravenous fluids and, if needed, blood transfusions to treat shock.

2. Surgical Treatment

• Vascular repair: Suturing or patching the injured vessel to restore normal flow.
• Interposition graft or bypass: Using a vein or synthetic graft to reroute blood around a damaged segment.
• Fasciotomy: Opening tight muscle compartments to prevent permanent damage from swelling and high pressure.
• Amputation: In rare, severe cases where the limb is non-salvageable due to prolonged ischaemia or extensive damage.

3. Minimally Invasive Endovascular Procedures

• Endovascular stenting: Placing a stent or stent-graft to seal vessel injuries, treat dissections, or support weakened vessel walls.
• Embolisation: Blocking specific injured vessels to control internal bleeding.

4. Post-Treatment Care & Rehabilitation

• Anticoagulant or antiplatelet medications to prevent clot formation where indicated.
• Regular vascular follow-up and imaging to monitor repair or stent patency.
• Physiotherapy and rehabilitation to restore strength, mobility, and function.

Complications of Vascular Trauma

If not treated in time, vascular trauma can lead to severe and sometimes permanent problems:

• Massive blood loss and life-threatening shock.
• Tissue death due to prolonged lack of blood flow.
• Loss of limb function or amputation.
• Blood clots that can travel to the lungs (pulmonary embolism) or brain (stroke).

Vascular trauma is a true medical emergency. Early diagnosis and rapid treatment can save lives, preserve limbs, and significantly improve recovery outcomes. If you or a loved one has suffered a serious injury with bleeding, swelling, or cold, pale limbs, seek immediate emergency care. Our vascular team provides advanced diagnostics and comprehensive treatment tailored to each patient’s needs.