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155 vascular injuries: a retrospective study in Kuwait, 1992-2000
Sami Asfar1, Jassim Al-Ali, Hussein Safar
1Vascular Surgery Unit, Department of Surgery, Mubarak Al-Kabeer Hospital, Safat, Kuwait. sami@hsc.kuniv.edu.kw
Objectives:
To audit the management of vascular trauma in Kuwait, 1992-2000.
Design:
Retrospective open study.
Setting:
Vascular surgery unit, teaching hospital, Kuwait.
Subjects:
155 patients with vascular injuries, most of which (n = 118) involved the extremities. 21 had neck injuries, 10 abdominal, and 6 chest.
Intervention:
Revascularisation usually using the long saphenous vein in addition to direct repair or end-to-end anastomosis.
Main Outcome:
Morbidity (amputation) and mortality.
Results:
Four lower limb grafts failed, two of which (2/69, 3%) required amputation. Overall, four patients died (3%), one of pulmonary embolism and 3 of severe injuries to major abdominal vessels. 3/10 patients with abdominal vascular trauma died. Mean (SD) follow up period was 4.4 (2) years.
Conclusions:
Civilian violence has increased in Kuwait. Vascular trauma to abdominal vessels is associated with high mortality. Autogenous saphenous vein forms an excellent conduit for revascularisation.
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