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Management of lower extremity arterial trauma
L C Martin1, M G McKenney, J L Sosa
1Department of Surgery, University of Miami School of Medicine, FL 33101.
The Journal of Trauma
|October 1, 1994
Summary
For lower extremity arterial trauma, vein grafts are superior for popliteal artery repair compared to PTFE grafts. Blunt trauma mechanisms increase graft failure and amputation risk, especially in popliteal and tibial injuries.
Area of Science:
- Vascular Surgery
- Trauma Management
- Reconstructive Surgery
Background:
- Extremity vascular trauma is a frequent challenge in urban trauma centers.
- Optimal management strategies for arterial injuries remain debated.
Purpose of the Study:
- To evaluate the outcomes of different graft materials for lower extremity arterial repairs.
- To identify factors influencing graft failure and amputation in vascular trauma.
Main Methods:
- Retrospective analysis of 188 patients with lower extremity arterial trauma.
- Comparison of vein grafts versus polytetrafluoroethylene (PTFE) grafts for arterial repair.
- Analysis of injury mechanisms (gunshot, stab, blunt) and associated venous injuries.
Main Results:
- PTFE graft failure was significantly higher in popliteal artery repairs compared to vein grafts (p < 0.01).
- Blunt trauma mechanisms were associated with higher graft failure rates (35%) and amputation.
- No significant difference in graft patency between vein and PTFE for iliac and femoral arteries.
Conclusions:
- Vein grafts are recommended for popliteal artery repairs due to superior patency.
- PTFE grafts demonstrate comparable outcomes to vein grafts for iliac and femoral artery repairs.
- Blunt mechanisms in popliteal and tibial injuries necessitate careful consideration due to increased amputation risk.