Limb Salvage Does Not Predict Functional Limb Outcome after Revascularization for Traumatic Acute Limb Ischemia

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Limb Revascularization

Background:

• Traumatic vascular injury causing acute limb ischemia (ALI) is uncommon but can lead to significant morbidity.
• This study reviews outcomes of patients with traumatic ALI managed by vascular surgeons.

Purpose of the Study:

• To describe a contemporary series of patients with traumatic ALI.
• To identify factors associated with limb salvage and functional limb outcomes.

Main Methods:

• Retrospective review of 68 patients with traumatic ALI (2013-2016).
• Data included demographics, injury severity, Rutherford classification, imaging, procedures, and outcomes (limb salvage, function).

Main Results:

• High limb salvage rates: 94% for upper extremity (UE) and 78% for lower extremity (LE).
• Functional outcomes varied: UE (57% minimal deficits), LE (68% minimal deficits).
• Rutherford class and number of operations predicted amputation and functional limb outcomes.

Conclusions:

• Revascularization for traumatic ALI achieves good limb salvage, particularly for Rutherford class 1-2 and UE injuries.
• Limb salvage does not always correlate with good functional limb outcomes.
• Complex injuries often require multiple surgical interventions.