The term "vascular trauma" refers to injury to a blood vessel—an artery, which carries blood to an extremity or an organ, or a vein, which returns blood to the heart. Vascular surgeons categorize these injuries by the type of trauma that caused them: blunt or penetrating injury.

• A blunt injury can occur when a blood vessel is crushed or stretched.   
• A penetrating injury can occur when a blood vessel is punctured, torn or severed.

Either type of vascular trauma can cause the blood vessel to clot (thrombosis) and interrupt blood flow to an organ or extremity, or cause bleeding which can lead to life-threatening hemorrhage.

• Dislocated Joints: If your knee dislocates, your popliteal artery (the vessel just behind the knee) is likely to be injured too. Trauma to the popliteal artery often can cause injury to the calf muscles and nerves, so it will require a prompt and complex repair which may be lengthy.
• Fractured Bones: If you fracture your upper arm bone (humerus) just above the elbow (supracondylar humerus fracture), you may also have injured the blood vessel that crosses the elbow joint (brachial artery). 
• Bleeding From the Wound or Swelling Near the Wound: There may be significant bleeding from the wound or a significant bulge can develop close to the wound or site of injury.
• Lightheadedness: Both external and internal bleeding from vascular trauma can lead to significant blood loss. You may feel lightheaded if significant bleeding occurs.
• Coolness, Loss of Color, Numbness, or Inability to Move the Extremity: Interruption of blood flow to the extremity may result in coolness and loss of color. Additionally, the affected extremity may feel numb, tingling or you may not be able to move the extremity.
• Stroke: Injuries to the blood vessels that carry blood to the brain may cause stroke or stroke-like symptoms. These include loss of movement, sensation, speech, or vision.

Many accidents and activities can lead to vascular trauma, including: 

• Home accidents
• Manipulation of neck or joints
• Bicycle and motorized vehicle accidents while driving or riding
• Job-related accidents
• Athletic injuries
• Falls
• Domestic violence
• Combat injuries
• Violent crime

A vascular injury can sometimes be diagnosed with physical examination alone. In the case of multiple injuries, deciding which of the problems needs to be dealt with most urgently is jointly made by medical specialists. These specialists often include trauma surgeons, vascular surgeons, orthopedic surgeons, and neurosurgeons, among others.

Tests May be Needed

Many vascular injuries can be subtle. Diagnostic imaging may be required to understand the nature and scope of the injury, and how best to treat it. Tests could include:

• Duplex ultrasound scanning
• CT scanning
• Angiography

Surgical Repair

Surgical repair of a blood vessel often requires a surgical bypass, primary repair, or a patch.

• Surgical bypasses use a prosthetic (an artificial graft), or a natural graft formed from a portion of a vein obtained from another location in your body, usually from your thigh or calf.
• Primary repair is when the end of the injured vessel is put directly together without a graft. This is done when there is no significant length of injury, and the ends of the vessels reach each other without tension.
• Patch repairs are done by obtaining your own vein or prosthetic material and used to patch an injured area of the blood vessel.
• If the injured vessel is a vessel, it may be repaired with a graft but sometimes can simply be tied off (ligated).

Endovascular Treatment

This is less invasive than open surgery and may be an option for some vascular injuries.  

• Through balloon angioplasty, some injured vessels can be widened to restore blood flow. 
• During the same procedure, if needed, a stent graft can be placed to provide internal support to help keep the vessel open.
• If there is disruption of the blood vessel with bleeding, a covered stent can be placed to cover the injured part of the vessel, restore blood flow, and control the bleeding.
• Coil embolization also helps stop bleeding by plugging blood vessels with coils.

Fasciotomy

This surgical procedure to repair muscle damage may be required.  

• In some injuries, until blood vessels are repaired, muscles can suffer damage due to impaired circulation. For example, when an extremity is injured, like the lower-leg, muscle damage can result in significant swelling. In severe cases, swollen muscles can be constrained by fascia (the thick layer of tissue beneath the skin that holds muscle groups together). Swelling can increase the pressure in these compartments and prevent blood circulation to the muscles, nerves, and skin which can lead to nerve and muscle damage and limb loss.
• If this happens, the fascia must be opened surgically, by incision, so muscles swell without undue pressure on the small vessels and nerves and the circulation to the leg does not become impaired.
• If the swelling is very pronounced, the skin must be left open, usually for several days. Once the swelling resolves, the incision can be closed. Occasionally, the swelling is so severe or so prolonged that a skin graft is needed to achieve wound closure.

Avoiding traumatic injuries may not always be possible. To reduce your risk: 

• Wear seat belts while driving or riding in a motorized vehicle. 
• Do not drive while intoxicated or ride with an intoxicated driver. 
• Take care when working with knives and tools. 
• Use caution when operating or standing near machinery. 
• Guard against slips and falls, especially on stairs, ladders or uneven or slippery surfaces. 
• Avoid volatile situations and environments.