Home › Vascular trauma
Blast and gunshot vascular injuries: pseudoaneurysm, AV fistula, occlusion
Combat injuries, especially blast injuries, often involve damage to arteries and veins. Some consequences are evident immediately; others appear weeks or months later: a pulsating mass, swelling, pain, weakness or a cold limb. A large proportion of these complications can now be repaired endovascularly, without repeat open surgery.
Complications we treat
- Pseudoaneurysm (false aneurysm, pulsatile hematoma) — a pulsating mass at the site of injury with a risk of rupture and bleeding
- Arteriovenous fistula — an abnormal connection between an artery and a vein: swelling, a bruit (a whooshing sound over the vessel), volume overload of the heart
- Post-traumatic occlusion or stenosis of an artery — pain, weakness, a cold limb
- Bleeding from hard-to-reach arteries of the pelvis, neck and limbs
- Complications after previous reconstructive vascular operations
Clinical signs that require assessment
A pulsating mass or swelling at the site of injury, a bruit over it, increasing pain, coldness or numbness of the limb, or a change in skin colour are indications for urgent vascular assessment.
Sudden coldness, pallor or numbness of the limb, or bleeding from the injury site: call an ambulance (103 in Ukraine). These may be signs of an acute arterial blockage or a ruptured pseudoaneurysm; they need emergency care, not a planned visit.
Diagnosis
Duplex ultrasound and CT angiography define the nature of the injury and the treatment strategy.
Endovascular treatment
Through an arterial puncture: implantation of a stent-graft (covered stent) that excludes a pseudoaneurysm or closes a fistula; embolization — occlusion of the damaged vessel from the inside; recanalization of a post-traumatic occlusion. This matters most when repeat open access through scar tissue carries a high risk. When needed, a hybrid procedure is performed together with the vascular surgery department.
Frequently asked questions
The injury was a long time ago. Is treatment still possible?
Yes. Pseudoaneurysms and fistulas are repaired months and even years after the injury; the decisive step is assessment.
Will I need another incision?
In most cases, no: the procedure is performed through an arterial puncture under local anesthesia.
Do you treat patients from abroad?
Yes. Referral and documentation are arranged at the consultation, which can be held online first.
Book a consultation
Vascular surgeon consultation at the Shalimov Center, 30 Akademika Shalimova St, Kyiv. Booking and questions go through the contact doctor, Yurii Vahis. Patients from other cities and abroad can arrange an online consultation.
+380 44 454 20 79