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Updated: Aug 19, 2025
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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
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The Mangled Extremity Severity Score (MESS) does not predict amputation in popliteal artery injury
Alexandra Gratl1, Michaela Kluckner2, Leonhard Gruber3
1Department of Vascular Surgery, Medical University Innsbruck, University Hospital of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Summary
Revascularization is crucial for traumatic popliteal artery injuries, achieving an 88% limb salvage rate. The Mangled Extremity Severity Score (MESS) did not predict amputation, but fasciotomy improved limb salvage outcomes.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Orthopedic Surgery
Background:
- Lower extremity trauma, particularly involving the popliteal artery, carries a high risk of limb loss, especially from blunt mechanisms.
- Prompt surgical intervention is critical for limb salvage in these complex injuries.
Purpose of the Study:
- To assess amputation risk in patients with traumatic popliteal artery lesions.
- To evaluate the predictive accuracy of the Mangled Extremity Severity Score (MESS) for limb salvage in these cases.
Main Methods:
- Retrospective analysis of 50 patients with isolated popliteal artery trauma treated between 1990 and 2020.
- Limb salvage was the primary outcome, with MESS used to assess trauma severity.
- Secondary outcomes included the influence of defined parameters on limb salvage.
Main Results:
- The overall limb salvage rate was 88% (44/50 patients), with revascularization attempted in all cases.
- A MESS score of 7 or higher was associated with significantly higher rates of fasciotomy (92.9% vs. 59.1%).
- MESS did not significantly predict delayed amputation (MESS 8.4 vs. 8.1; p=0.765).
Conclusions:
- Revascularization should be prioritized for all isolated popliteal artery injuries.
- The MESS score is not a reliable predictor of delayed amputation in this patient cohort.
- Fasciotomy is an important adjunctive measure for improving limb salvage rates.
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