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Femoral-Femoral Bypass for Limb Salvage to Correct Common Iliac Occlusion after Lower Extremity Trauma
Christine Castater1,2, Ben Hazen1,2, G Stewart Barrett1,3
171741Grady Memorial Hospital, Atlanta, GA, USA.
Insights
Blunt trauma can complicate lower extremity vascular repair with chronic iliac artery occlusion. Extra-anatomic bypass grafting successfully restored perfusion and aided limb salvage in a complex pedestrian accident case.
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Orthopedic Surgery
Background:
- Roadway injuries frequently cause lower extremity vascular trauma, necessitating hemorrhage control and distal perfusion restoration.
- Effective management of severe limb trauma requires addressing both soft tissue and vascular injuries.
Observation:
- A 50-year-old male sustained severe bilateral lower extremity injuries in a pedestrian versus auto accident.
- Emergent lower extremity amputations were performed, revealing chronic left common iliac artery occlusion.
Findings:
- A femoral-femoral bypass was successfully utilized to restore perfusion to the left lower extremity.
- This extra-anatomic bypass facilitated healing of a left below-the-knee amputation.
Implications:
- Chronic vascular disease can significantly complicate the management of acute lower extremity trauma.
- Bypass grafting is a viable strategy for limb salvage when traditional reperfusion methods are insufficient.
- Optimizing perfusion is critical for successful wound healing and limb salvage in complex trauma cases.
Background:
Roadway injuries are a leading cause of lower extremity vascular trauma. Treating these injuries involves controlling life-threatening hemorrhage and restoring distal perfusion.
Materials And Methods:
We describe a unique presentation of chronic iliac artery occlusion in the setting of blunt trauma requiring extra-anatomic bypass for maximal limb salvage.
Results:
A 50-year-old male presented after a pedestrian versus auto accident. He had mangled bilateral lower extremities and was taken emergently for lower extremity amputations. He was found to have chronic left common iliac occlusion and a femoral-femoral bypass was performed to assist with healing his left below-the-knee amputation.
Discussion:
Lack of adequate perfusion can cause poor outcomes in limb salvage. This case demonstrated that lower extremity trauma can be complicated by chronic vascular disease. Reperfusion and adequate wound healing can be accomplished by using bypass grafting after more traditional reperfusion techniques fail.
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