ABSTRACT
It is estimated that vascular injuries occur in 0.6%-1% of pediatric trauma patients. The contribution of ­vascular trauma to death and disability is not known. In contrast to adult vascular injuries, minimal ­established evidence for the management of pediatric ­vascular injury exists. Nontraumatic acute limb ischemia due to vasospasm in neonates is generally treated conservatively through the use of heparin anticoagulation and/or systemic thrombolytic therapy. Unfortunately, the use of anticoagulants is often contraindicated in the setting of trauma. Conventional angiography is the gold standard diagnostic modality for vascular injury, but it is invasive and has higher morbidity in younger children. Aspirin, unfractionated heparin, low-molecular-weight ­heparin, and warfarin remain the most common medications used for anticoagulation in the vascular patient. Blunt carotid injury in the pediatric population is less common overall in the pediatric population, likely secondary to the increased pliability of children's blood vessels.
