ABSTRACT
Mechanism of vascular injury Vascular injuries may be blunt, penetrating (high versus low energy) or iatrogenic. For both blunt and penetrating injuries, the injuring force is directed from the external environment (i.e. out to in), passing through the surrounding tissues, with a higher likelihood of additional associated injury including additional bleeding and haematoma formation within the tissues (in addition to the vascular injury itself). Injured vessels (typically large named vessels) will have perivascular, surrounding haematoma (on imaging) or traumatic streaking in the adventitial plane (even if small). An iatrogenic injury however, typically results from injury during an endovascular procedure (or other vessel instrumentation) and may not have the same pattern of surrounding haematoma and inflammation (unless the vessel wall itself is fully traversed by the instrument) and may be confined to a small intimal tear or luminal irregularity only.
