Wednesday, November 18, 2020

An Overview of Iatrogenic Vascular Lesions in LBW and ELBW



Based in Staten Island, Dr. Brian Gilchrist is a pediatric surgeon with over 30 years of experience. Dr. Brian Gilchrist has published numerous articles in medical journals on topics including pilonidal disease, necrotizing enterocolitis, and the treatment of iatrogenic vascular lesions.

Iatrogenic conditions are adverse effects or states of illness resulting from medical treatment. Such a condition might be caused by a mistake made during treatment or diagnosis by any of the health care team members. Iatrogenic vascular lesions are abnormalities of the tissues and skin in babies, and often involve acquired damage or injuries in the tissue or organs such as tumors and ulcers.

Iatrogenic complications are becoming more frequent due to the increased number of minimally invasive therapeutic and diagnostic procedures performed. Although typically these complications have no real clinical impact, they may result in negative outcomes. When treating vascular lesions such as pseudoaneurysm (PA), a medical condition involving an injured blood vessel wall with leaking blood collecting around the surrounding tissue, experts recommend using transarterial embolization (TAE). This procedure entails blocking the blood supply to an abnormal tissue area or tumor.

Low birth weight (LBW) and extremely low birth weight (ELBW) neonates (newborn babies under four weeks old) are at even greater risk of developing iatrogenic vascular lesions. Experts advocate for aggressive medical treatment, microsurgery, or a combination of both to prevent late sequelae.

Aggressive and increased treatment in hospitals' neonatal intensive care units (NICUs) has significantly improved LBW and ELBW neonates' long-term outcomes. However, it has led to an increase in the risk of iatrogenic vascular lesions such as gangrene, thromboses, and aneurysms due to arterial blood sampling or repeated venipuncture. As such, these lesions need a correct, noninvasive clinical diagnosis and treatment using microvascular techniques. 

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